How much rates vary
Facilitymedian $240 · 10th to 90th $174 to $550Professionalmedian $178 · 10th to 90th $129 to $288
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 $186.21 Median $186.21 Typical High $190.55 | Facility | None | $186.21 | $186.21 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $186.21 Typical High $190.55 | Professional | None | $165.96 | $186.21 | $190.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $389.05 | Facility | None | $363.08 | $363.08 | $389.05 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $194.98 | Professional | None | $169.82 | $169.82 | $194.98 |
CareFirst Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $251.19 | Professional | None | $190.55 | $190.55 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $173.78 | Professional | None | $128.82 | $128.82 | $173.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $257.04 Median $363.08 Typical High $478.63 | Professional | None | $257.04 | $363.08 | $478.63 |
Medcost Setting Professional Modifier None Typical Low $213.80 Median $239.88 Typical High $331.13 | Professional | None | $213.80 | $239.88 | $331.13 |
Medcost Setting Facility Modifier None Typical Low $100.00 Median $194.98 Typical High $239.88 | Facility | None | $100.00 | $194.98 | $239.88 |
Medcost Setting Professional Modifier None Typical Low $125.89 Median $165.96 Typical High $239.88 | Professional | None | $125.89 | $165.96 | $239.88 |
Sentara Setting Facility Modifier None Typical Low $177.83 Median $251.19 Typical High $776.25 | Facility | None | $177.83 | $251.19 | $776.25 |
Sentara Setting Professional Modifier None Typical Low $194.98 Median $269.15 Typical High $549.54 | Professional | None | $194.98 | $269.15 | $549.54 |
United Setting Facility Modifier None Typical Low $186.21 Median $229.09 Typical High $380.19 | Facility | None | $186.21 | $229.09 | $380.19 |
United Setting Professional Modifier None Typical Low $151.36 Median $177.83 Typical High $269.15 | Professional | None | $151.36 | $177.83 | $269.15 |
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 $83.18 Median $93.33 Typical High $95.50 | Professional | 52 · Reduced service | $83.18 | $93.33 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $38.02 Typical High $38.02 | Professional | 53 · Discontinued | $33.11 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $28.18 Typical High $28.84 | Professional | 55 · Aftercare only | $25.12 | $28.18 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $18.62 Typical High $19.05 | Professional | 56 · Pre-op care only | $16.60 | $18.62 | $19.05 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $17.38 Median $17.38 Typical High $22.39 | Professional | RR · Rental | $17.38 | $17.38 | $22.39 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $128.82 Median $131.83 Typical High $138.04 | Professional | UE · Used equipment | $128.82 | $131.83 | $138.04 |
Where Virginia sits
The same service costs 4.0 times more in Hawaii than in Florida. 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· 34th of 51
$178
HI $525FL $132
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.