How much rates vary
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 $5,248.07 Median $5,248.07 Typical High $5,370.32 | Facility | None | $5,248.07 | $5,248.07 | $5,370.32 |
Aetna Setting Professional Modifier None Typical Low $5,011.87 Median $5,248.07 Typical High $5,370.32 | Professional | None | $5,011.87 | $5,248.07 | $5,370.32 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,232.93 Median $10,232.93 Typical High $10,964.78 | Facility | None | $10,232.93 | $10,232.93 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $6,918.31 | Professional | None | $5,623.41 | $5,623.41 | $6,918.31 |
CareFirst Setting Professional Modifier None Typical Low $5,888.44 Median $5,888.44 Typical High $7,079.46 | Professional | None | $5,888.44 | $5,888.44 | $7,079.46 |
Cigna Setting Facility Modifier None Typical Low $4,466.84 Median $6,606.93 Typical High $6,606.93 | Facility | None | $4,466.84 | $6,606.93 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $6,606.93 | Professional | None | $4,897.79 | $4,897.79 | $6,606.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $7,244.36 Median $10,232.93 Typical High $13,182.57 | Professional | None | $7,244.36 | $10,232.93 | $13,182.57 |
Medcost Setting Professional Modifier None Typical Low $5,128.61 Median $6,760.83 Typical High $9,332.54 | Professional | None | $5,128.61 | $6,760.83 | $9,332.54 |
Medcost Setting Facility Modifier None Typical Low $3,235.94 Median $5,495.41 Typical High $6,606.93 | Facility | None | $3,235.94 | $5,495.41 | $6,606.93 |
Medcost Setting Professional Modifier None Typical Low $5,495.41 Median $6,309.57 Typical High $7,244.36 | Professional | None | $5,495.41 | $6,309.57 | $7,244.36 |
Sentara Setting Facility Modifier None Typical Low $4,897.79 Median $7,413.10 Typical High $15,488.17 | Facility | None | $4,897.79 | $7,413.10 | $15,488.17 |
Sentara Setting Professional Modifier None Typical Low $5,011.87 Median $7,762.47 Typical High $14,125.38 | Professional | None | $5,011.87 | $7,762.47 | $14,125.38 |
United Setting Facility Modifier None Typical Low $12,589.25 Median $12,589.25 Typical High $15,135.61 | Facility | None | $12,589.25 | $12,589.25 | $15,135.61 |
United Setting Professional Modifier None Typical Low $4,570.88 Median $5,011.87 Typical High $7,585.78 | Professional | None | $4,570.88 | $5,011.87 | $7,585.78 |
4 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 55 · Aftercare only Typical Low $758.58 Median $794.33 Typical High $794.33 | Professional | 55 · Aftercare only | $758.58 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $501.19 Median $524.81 Typical High $537.03 | Professional | 56 · Pre-op care only | $501.19 | $524.81 | $537.03 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $562.34 Median $562.34 Typical High $724.44 | Professional | RR · Rental | $562.34 | $562.34 | $724.44 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4,265.80 Median $4,265.80 Typical High $4,570.88 | Professional | UE · Used equipment | $4,265.80 | $4,265.80 | $4,570.88 |
Where Virginia sits
The same service costs 2.3 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· 35th of 51
$5,623
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.