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 $1,548.82 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,548.82 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,412.54 | $1,548.82 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $3,162.28 | Facility | None | $2,951.21 | $2,951.21 | $3,162.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,819.70 | Professional | None | $1,479.11 | $1,479.11 | $1,819.70 |
CareFirst Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $2,041.74 | Professional | None | $1,548.82 | $1,548.82 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $1,513.56 Typical High $1,513.56 | Facility | None | $1,288.25 | $1,513.56 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,513.56 | Professional | None | $1,122.02 | $1,122.02 | $1,513.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,089.30 Median $2,951.21 Typical High $3,890.45 | Professional | None | $2,089.30 | $2,951.21 | $3,890.45 |
Medcost Setting Professional Modifier None Typical Low $1,737.80 Median $1,949.84 Typical High $2,691.53 | Professional | None | $1,737.80 | $1,949.84 | $2,691.53 |
Medcost Setting Facility Modifier None Typical Low $870.96 Median $1,584.89 Typical High $1,949.84 | Facility | None | $870.96 | $1,584.89 | $1,949.84 |
Medcost Setting Professional Modifier None Typical Low $1,412.54 Median $1,584.89 Typical High $1,949.84 | Professional | None | $1,412.54 | $1,584.89 | $1,949.84 |
Sentara Setting Facility Modifier None Typical Low $1,445.44 Median $2,041.74 Typical High $6,165.95 | Facility | None | $1,445.44 | $2,041.74 | $6,165.95 |
Sentara Setting Professional Modifier None Typical Low $1,584.89 Median $2,187.76 Typical High $4,466.84 | Professional | None | $1,584.89 | $2,187.76 | $4,466.84 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $1,659.59 Typical High $3,311.31 | Facility | None | $1,621.81 | $1,659.59 | $3,311.31 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $2,187.76 | Professional | None | $1,318.26 | $1,445.44 | $2,187.76 |
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 $724.44 Median $758.58 Typical High $776.25 | Professional | 52 · Reduced service | $724.44 | $758.58 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $288.40 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $229.09 Typical High $234.42 | Professional | 55 · Aftercare only | $218.78 | $229.09 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $144.54 | $154.88 | $154.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $147.91 Median $147.91 Typical High $194.98 | Professional | RR · Rental | $147.91 | $147.91 | $194.98 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,122.02 Median $1,122.02 Typical High $1,202.26 | Professional | UE · Used equipment | $1,122.02 | $1,122.02 | $1,202.26 |
Where Virginia sits
The same service costs 3.2 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· 33rd of 51
$1,514
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.