How much rates vary
Facilitymedian $603 · 10th to 90th $457 to $1,318Professionalmedian $525 · 10th to 90th $427 to $724
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 $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $933.25 | Facility | None | $870.96 | $870.96 | $933.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $588.84 | Professional | None | $524.81 | $524.81 | $588.84 |
CareFirst Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $602.56 | Professional | None | $467.74 | $467.74 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $588.84 Typical High $588.84 | Facility | None | $389.05 | $588.84 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $588.84 | Professional | None | $426.58 | $426.58 | $588.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $616.60 Median $870.96 Typical High $1,148.15 | Professional | None | $616.60 | $870.96 | $1,148.15 |
Medcost Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $812.83 | Professional | None | $575.44 | $575.44 | $812.83 |
Medcost Setting Facility Modifier None Typical Low $309.03 Median $467.74 Typical High $575.44 | Facility | None | $309.03 | $467.74 | $575.44 |
Medcost Setting Professional Modifier None Typical Low $389.05 Median $489.78 Typical High $575.44 | Professional | None | $389.05 | $489.78 | $575.44 |
Sentara Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $1,905.46 | Facility | None | $426.58 | $602.56 | $1,905.46 |
Sentara Setting Professional Modifier None Typical Low $467.74 Median $645.65 Typical High $1,318.26 | Professional | None | $467.74 | $645.65 | $1,318.26 |
United Setting Facility Modifier None Typical Low $501.19 Median $524.81 Typical High $1,174.90 | Facility | None | $501.19 | $524.81 | $1,174.90 |
United Setting Professional Modifier None Typical Low $398.11 Median $426.58 Typical High $660.69 | Professional | None | $398.11 | $426.58 | $660.69 |
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 $229.09 Median $229.09 Typical High $229.09 | Professional | 52 · Reduced service | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | 53 · Discontinued | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $69.18 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $45.71 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $53.70 Median $53.70 Typical High $67.61 | Professional | RR · Rental | $53.70 | $53.70 | $67.61 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $389.05 Median $398.11 Typical High $416.87 | Professional | UE · Used equipment | $389.05 | $398.11 | $416.87 |
Where Virginia sits
The same service costs 2.8 times more in Hawaii than in West Virginia. 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
$525
HI $1,175WV $427
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.