How much rates vary
Facilitymedian $257 · 10th to 90th $195 to $575Professionalmedian $195 · 10th to 90th $148 to $302
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $199.53 | Facility | None | $194.98 | $194.98 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $194.98 Typical High $199.53 | Professional | None | $186.21 | $194.98 | $199.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $398.11 | Facility | None | $380.19 | $380.19 | $398.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $223.87 | Professional | None | $194.98 | $194.98 | $223.87 |
CareFirst Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $257.04 | Professional | None | $199.53 | $199.53 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $204.17 Typical High $204.17 | Facility | None | $141.25 | $204.17 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $204.17 | Professional | None | $147.91 | $147.91 | $204.17 |
Kaiser Permanente Setting Professional Modifier None Typical Low $263.03 Median $380.19 Typical High $489.78 | Professional | None | $263.03 | $380.19 | $489.78 |
Medcost Setting Professional Modifier None Typical Low $223.87 Median $245.47 Typical High $346.74 | Professional | None | $223.87 | $245.47 | $346.74 |
Medcost Setting Facility Modifier None Typical Low $114.82 Median $204.17 Typical High $245.47 | Facility | None | $114.82 | $204.17 | $245.47 |
Medcost Setting Professional Modifier None Typical Low $151.36 Median $199.53 Typical High $245.47 | Professional | None | $151.36 | $199.53 | $245.47 |
Sentara Setting Facility Modifier None Typical Low $186.21 Median $263.03 Typical High $812.83 | Facility | None | $186.21 | $263.03 | $812.83 |
Sentara Setting Professional Modifier None Typical Low $204.17 Median $281.84 Typical High $575.44 | Professional | None | $204.17 | $281.84 | $575.44 |
United Setting Facility Modifier None Typical Low $181.97 Median $218.78 Typical High $446.68 | Facility | None | $181.97 | $218.78 | $446.68 |
United Setting Professional Modifier None Typical Low $165.96 Median $186.21 Typical High $281.84 | Professional | None | $165.96 | $186.21 | $281.84 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $93.33 Median $97.72 Typical High $100.00 | Professional | 52 · Reduced service | $93.33 | $97.72 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $38.90 Typical High $39.81 | Professional | 53 · Discontinued | $37.15 | $38.90 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $29.51 Typical High $29.51 | Professional | 55 · Aftercare only | $27.54 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $19.50 Typical High $19.95 | Professional | 56 · Pre-op care only | $18.62 | $19.50 | $19.95 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $20.42 Median $20.42 Typical High $26.30 | Professional | RR · Rental | $20.42 | $20.42 | $26.30 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $147.91 Median $151.36 Typical High $158.49 | Professional | UE · Used equipment | $147.91 | $151.36 | $158.49 |
Where Virginia sits
The same service costs 3.3 times more in Hawaii than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Virginia· 35th of 51
$200
HI $501DE $151
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.