How much rates vary
Facilitymedian $251 · 10th to 90th $186 to $537Professionalmedian $219 · 10th to 90th $174 to $295
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 $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $380.19 | Facility | None | $354.81 | $354.81 | $380.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $269.15 | Professional | None | $218.78 | $218.78 | $269.15 |
CareFirst Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $245.47 | Professional | None | $186.21 | $186.21 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $245.47 Typical High $245.47 | Facility | None | $162.18 | $245.47 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $245.47 | Professional | None | $177.83 | $177.83 | $245.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $251.19 Median $354.81 Typical High $467.74 | Professional | None | $251.19 | $354.81 | $467.74 |
Medcost Setting Professional Modifier None Typical Low $208.93 Median $234.42 Typical High $331.13 | Professional | None | $208.93 | $234.42 | $331.13 |
Medcost Setting Facility Modifier None Typical Low $123.03 Median $190.55 Typical High $234.42 | Facility | None | $123.03 | $190.55 | $234.42 |
Medcost Setting Professional Modifier None Typical Low $154.88 Median $194.98 Typical High $234.42 | Professional | None | $154.88 | $194.98 | $234.42 |
Sentara Setting Facility Modifier None Typical Low $173.78 Median $245.47 Typical High $776.25 | Facility | None | $173.78 | $245.47 | $776.25 |
Sentara Setting Professional Modifier None Typical Low $190.55 Median $263.03 Typical High $537.03 | Professional | None | $190.55 | $263.03 | $537.03 |
United Setting Facility Modifier None Typical Low $234.42 Median $281.84 Typical High $478.63 | Facility | None | $234.42 | $281.84 | $478.63 |
United Setting Professional Modifier None Typical Low $162.18 Median $173.78 Typical High $269.15 | Professional | None | $162.18 | $173.78 | $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 $93.33 Median $93.33 Typical High $93.33 | Professional | 52 · Reduced service | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | 53 · Discontinued | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $28.18 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $18.62 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $21.88 Median $21.88 Typical High $28.18 | Professional | RR · Rental | $21.88 | $21.88 | $28.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $162.18 Median $162.18 Typical High $177.83 | Professional | UE · Used equipment | $162.18 | $162.18 | $177.83 |
Where Virginia sits
The same service costs 3.6 times more in Hawaii than in Tennessee. 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· 32nd of 51
$219
HI $646TN $178
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.