How much rates vary
Facilitymedian $417 · 10th to 90th $316 to $912Professionalmedian $316 · 10th to 90th $295 to $575
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 $309.03 Median $309.03 Typical High $316.23 | Facility | None | $309.03 | $309.03 | $316.23 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $316.23 | Professional | None | $309.03 | $309.03 | $316.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $645.65 | Facility | None | $602.56 | $602.56 | $645.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $309.03 Median $457.09 Typical High $602.56 | Professional | None | $309.03 | $457.09 | $602.56 |
CareFirst Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $416.87 | Professional | None | $316.23 | $316.23 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $398.11 Typical High $398.11 | Facility | None | $288.40 | $398.11 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $398.11 | Professional | None | $295.12 | $295.12 | $398.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $426.58 Median $602.56 Typical High $776.25 | Professional | None | $426.58 | $602.56 | $776.25 |
Medcost Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $549.54 | Professional | None | $398.11 | $398.11 | $549.54 |
Medcost Setting Facility Modifier None Typical Low $208.93 Median $323.59 Typical High $398.11 | Facility | None | $208.93 | $323.59 | $398.11 |
Medcost Setting Professional Modifier None Typical Low $263.03 Median $331.13 Typical High $398.11 | Professional | None | $263.03 | $331.13 | $398.11 |
Sentara Setting Facility Modifier None Typical Low $295.12 Median $416.87 Typical High $1,288.25 | Facility | None | $295.12 | $416.87 | $1,288.25 |
Sentara Setting Professional Modifier None Typical Low $323.59 Median $446.68 Typical High $912.01 | Professional | None | $323.59 | $446.68 | $912.01 |
United Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $812.83 | Facility | None | $398.11 | $398.11 | $812.83 |
United Setting Professional Modifier None Typical Low $275.42 Median $295.12 Typical High $457.09 | Professional | None | $275.42 | $295.12 | $457.09 |
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 $154.88 Median $154.88 Typical High $158.49 | Professional | 52 · Reduced service | $154.88 | $154.88 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | 55 · Aftercare only | $46.77 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $30.90 Typical High $31.62 | Professional | 56 · Pre-op care only | $30.90 | $30.90 | $31.62 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $36.31 Median $36.31 Typical High $47.86 | Professional | RR · Rental | $36.31 | $36.31 | $47.86 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $269.15 Median $269.15 Typical High $288.40 | Professional | UE · Used equipment | $269.15 | $269.15 | $288.40 |
Where Virginia sits
The same service costs 3.7 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· 38th of 51
$355
HI $1,096DE $295
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.