How much rates vary
Facilitymedian $275 · 10th to 90th $191 to $646Professionalmedian $219 · 10th to 90th $166 to $339
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 $218.78 Median $218.78 Typical High $223.87 | Facility | None | $218.78 | $218.78 | $223.87 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $218.78 Typical High $223.87 | Professional | None | $204.17 | $218.78 | $223.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $446.68 | Facility | None | $426.58 | $426.58 | $446.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $251.19 | Professional | None | $218.78 | $218.78 | $251.19 |
CareFirst Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $288.40 | Professional | None | $223.87 | $223.87 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $229.09 Typical High $229.09 | Facility | None | $158.49 | $229.09 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $229.09 | Professional | None | $165.96 | $165.96 | $229.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $295.12 Median $426.58 Typical High $549.54 | Professional | None | $295.12 | $426.58 | $549.54 |
Medcost Setting Professional Modifier None Typical Low $251.19 Median $275.42 Typical High $389.05 | Professional | None | $251.19 | $275.42 | $389.05 |
Medcost Setting Facility Modifier None Typical Low $128.82 Median $229.09 Typical High $275.42 | Facility | None | $128.82 | $229.09 | $275.42 |
Medcost Setting Professional Modifier None Typical Low $208.93 Median $229.09 Typical High $281.84 | Professional | None | $208.93 | $229.09 | $281.84 |
Sentara Setting Facility Modifier None Typical Low $208.93 Median $288.40 Typical High $912.01 | Facility | None | $208.93 | $288.40 | $912.01 |
Sentara Setting Professional Modifier None Typical Low $229.09 Median $309.03 Typical High $645.65 | Professional | None | $229.09 | $309.03 | $645.65 |
United Setting Facility Modifier None Typical Low $151.36 Median $190.55 Typical High $501.19 | Facility | None | $151.36 | $190.55 | $501.19 |
United Setting Professional Modifier None Typical Low $186.21 Median $208.93 Typical High $309.03 | Professional | None | $186.21 | $208.93 | $309.03 |
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 $102.33 Median $109.65 Typical High $109.65 | Professional | 52 · Reduced service | $102.33 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $43.65 Typical High $44.67 | Professional | 53 · Discontinued | $40.74 | $43.65 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $33.11 Typical High $33.11 | Professional | 55 · Aftercare only | $30.90 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $21.88 Typical High $22.39 | Professional | 56 · Pre-op care only | $20.42 | $21.88 | $22.39 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $22.91 Median $22.91 Typical High $28.84 | Professional | RR · Rental | $22.91 | $22.91 | $28.84 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $165.96 Median $169.82 Typical High $177.83 | Professional | UE · Used equipment | $165.96 | $169.82 | $177.83 |
Where Virginia sits
The same service costs 2.7 times more in Montana 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· 37th of 51
$224
MT $457DE $170
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.