How much rates vary
Facilitymedian $389 · 10th to 90th $275 to $851Professionalmedian $295 · 10th to 90th $269 to $457
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 $288.40 Median $288.40 Typical High $295.12 | Facility | None | $288.40 | $288.40 | $295.12 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $288.40 Typical High $295.12 | Professional | None | $281.84 | $288.40 | $295.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $588.84 | Facility | None | $562.34 | $562.34 | $588.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $363.08 | Professional | None | $295.12 | $295.12 | $363.08 |
CareFirst Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $389.05 | Professional | None | $295.12 | $295.12 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $363.08 Typical High $363.08 | Facility | None | $245.47 | $363.08 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $363.08 | Professional | None | $269.15 | $269.15 | $363.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $389.05 Median $562.34 Typical High $724.44 | Professional | None | $389.05 | $562.34 | $724.44 |
Medcost Setting Professional Modifier None Typical Low $331.13 Median $363.08 Typical High $512.86 | Professional | None | $331.13 | $363.08 | $512.86 |
Medcost Setting Facility Modifier None Typical Low $169.82 Median $302.00 Typical High $363.08 | Facility | None | $169.82 | $302.00 | $363.08 |
Medcost Setting Professional Modifier None Typical Low $269.15 Median $302.00 Typical High $380.19 | Professional | None | $269.15 | $302.00 | $380.19 |
Sentara Setting Facility Modifier None Typical Low $269.15 Median $389.05 Typical High $1,202.26 | Facility | None | $269.15 | $389.05 | $1,202.26 |
Sentara Setting Professional Modifier None Typical Low $288.40 Median $416.87 Typical High $851.14 | Professional | None | $288.40 | $416.87 | $851.14 |
United Setting Facility Modifier None Typical Low $239.88 Median $323.59 Typical High $660.69 | Facility | None | $239.88 | $323.59 | $660.69 |
United Setting Professional Modifier None Typical Low $245.47 Median $275.42 Typical High $416.87 | Professional | None | $245.47 | $275.42 | $416.87 |
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 $141.25 Median $144.54 Typical High $147.91 | Professional | 52 · Reduced service | $141.25 | $144.54 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $57.54 Typical High $58.88 | Professional | 53 · Discontinued | $56.23 | $57.54 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $43.65 Typical High $43.65 | Professional | 55 · Aftercare only | $41.69 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.84 Typical High $29.51 | Professional | 56 · Pre-op care only | $28.18 | $28.84 | $29.51 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $29.51 Median $29.51 Typical High $38.90 | Professional | RR · Rental | $29.51 | $29.51 | $38.90 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $218.78 Median $218.78 Typical High $239.88 | Professional | UE · Used equipment | $218.78 | $218.78 | $239.88 |
Where Virginia sits
The same service costs 2.6 times more in Hawaii than in Alabama. 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· 38th of 51
$295
HI $708AL $269
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.