How much rates vary
Facilitymedian $174 · 10th to 90th $132 to $380Professionalmedian $135 · 10th to 90th $102 to $204
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 $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $131.83 Typical High $131.83 | Professional | None | $123.03 | $131.83 | $131.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $269.15 | Facility | None | $257.04 | $257.04 | $269.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $162.18 | Professional | None | $134.90 | $134.90 | $162.18 |
CareFirst Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $173.78 | Professional | None | $134.90 | $134.90 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $138.04 Typical High $138.04 | Facility | None | $102.33 | $138.04 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $138.04 | Professional | None | $102.33 | $102.33 | $138.04 |
Kaiser Permanente Setting Professional Modifier None Typical Low $177.83 Median $257.04 Typical High $331.13 | Professional | None | $177.83 | $257.04 | $331.13 |
Medcost Setting Professional Modifier None Typical Low $151.36 Median $165.96 Typical High $234.42 | Professional | None | $151.36 | $165.96 | $234.42 |
Medcost Setting Facility Modifier None Typical Low $79.43 Median $138.04 Typical High $165.96 | Facility | None | $79.43 | $138.04 | $165.96 |
Medcost Setting Professional Modifier None Typical Low $107.15 Median $138.04 Typical High $165.96 | Professional | None | $107.15 | $138.04 | $165.96 |
Sentara Setting Facility Modifier None Typical Low $123.03 Median $173.78 Typical High $549.54 | Facility | None | $123.03 | $173.78 | $549.54 |
Sentara Setting Professional Modifier None Typical Low $138.04 Median $186.21 Typical High $380.19 | Professional | None | $138.04 | $186.21 | $380.19 |
United Setting Facility Modifier None Typical Low $147.91 Median $154.88 Typical High $302.00 | Facility | None | $147.91 | $154.88 | $302.00 |
United Setting Professional Modifier None Typical Low $112.20 Median $125.89 Typical High $186.21 | Professional | None | $112.20 | $125.89 | $186.21 |
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 $61.66 Median $66.07 Typical High $66.07 | Professional | 52 · Reduced service | $61.66 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $26.30 Typical High $26.92 | Professional | 53 · Discontinued | $24.55 | $26.30 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $19.95 Typical High $19.95 | Professional | 55 · Aftercare only | $18.62 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $13.18 Typical High $13.18 | Professional | 56 · Pre-op care only | $12.30 | $13.18 | $13.18 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $13.49 Median $13.49 Typical High $17.78 | Professional | RR · Rental | $13.49 | $13.49 | $17.78 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $100.00 Median $100.00 Typical High $107.15 | Professional | UE · Used equipment | $100.00 | $100.00 | $107.15 |
Where Virginia sits
The same service costs 3.5 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· 36th of 51
$135
HI $363DE $102
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.