How much rates vary
Facilitymedian $490 · 10th to 90th $363 to $1,072Professionalmedian $380 · 10th to 90th $288 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 $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $758.58 | Facility | None | $724.44 | $724.44 | $758.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $436.52 | Professional | None | $380.19 | $380.19 | $436.52 |
CareFirst Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $489.78 | Professional | None | $380.19 | $380.19 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $398.11 Typical High $398.11 | Facility | None | $380.19 | $398.11 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $398.11 | Professional | None | $288.40 | $288.40 | $398.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $501.19 Median $724.44 Typical High $933.25 | Professional | None | $501.19 | $724.44 | $933.25 |
Medcost Setting Professional Modifier None Typical Low $426.58 Median $467.74 Typical High $660.69 | Professional | None | $426.58 | $467.74 | $660.69 |
Medcost Setting Facility Modifier None Typical Low $223.87 Median $389.05 Typical High $467.74 | Facility | None | $223.87 | $389.05 | $467.74 |
Medcost Setting Professional Modifier None Typical Low $302.00 Median $389.05 Typical High $467.74 | Professional | None | $302.00 | $389.05 | $467.74 |
Sentara Setting Facility Modifier None Typical Low $346.74 Median $489.78 Typical High $1,548.82 | Facility | None | $346.74 | $489.78 | $1,548.82 |
Sentara Setting Professional Modifier None Typical Low $389.05 Median $524.81 Typical High $1,071.52 | Professional | None | $389.05 | $524.81 | $1,071.52 |
United Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $1,023.29 | Facility | None | $363.08 | $363.08 | $1,023.29 |
United Setting Professional Modifier None Typical Low $316.23 Median $354.81 Typical High $524.81 | Professional | None | $316.23 | $354.81 | $524.81 |
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 $186.21 Median $186.21 Typical High $186.21 | Professional | 52 · Reduced service | $186.21 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $74.13 Typical High $75.86 | Professional | 53 · Discontinued | $74.13 | $74.13 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $56.23 Typical High $56.23 | Professional | 55 · Aftercare only | $54.95 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $37.15 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $39.81 Median $39.81 Typical High $50.12 | Professional | RR · Rental | $39.81 | $39.81 | $50.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $288.40 Median $295.12 Typical High $309.03 | Professional | UE · Used equipment | $288.40 | $295.12 | $309.03 |
Where Virginia sits
The same service costs 2.8 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· 42nd of 51
$380
HI $794DE $288
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.