How much rates vary
Facilitymedian $166 · 10th to 90th $129 to $372Professionalmedian $126 · 10th to 90th $120 to $195
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 $125.89 Median $125.89 Typical High $128.82 | Facility | None | $125.89 | $125.89 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $125.89 Typical High $128.82 | Professional | None | $123.03 | $125.89 | $128.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $257.04 | Facility | None | $245.47 | $245.47 | $257.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $144.54 | Professional | None | $125.89 | $125.89 | $144.54 |
CareFirst Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $165.96 | Professional | None | $128.82 | $128.82 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $165.96 Typical High $165.96 | Facility | None | $107.15 | $165.96 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $165.96 | Professional | None | $120.23 | $120.23 | $165.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $169.82 Median $245.47 Typical High $316.23 | Professional | None | $169.82 | $245.47 | $316.23 |
Medcost Setting Professional Modifier None Typical Low $144.54 Median $158.49 Typical High $223.87 | Professional | None | $144.54 | $158.49 | $223.87 |
Medcost Setting Facility Modifier None Typical Low $74.13 Median $131.83 Typical High $158.49 | Facility | None | $74.13 | $131.83 | $158.49 |
Medcost Setting Professional Modifier None Typical Low $107.15 Median $131.83 Typical High $158.49 | Professional | None | $107.15 | $131.83 | $158.49 |
Sentara Setting Facility Modifier None Typical Low $120.23 Median $169.82 Typical High $524.81 | Facility | None | $120.23 | $169.82 | $524.81 |
Sentara Setting Professional Modifier None Typical Low $131.83 Median $177.83 Typical High $371.54 | Professional | None | $131.83 | $177.83 | $371.54 |
United Setting Facility Modifier None Typical Low $138.04 Median $141.25 Typical High $288.40 | Facility | None | $138.04 | $141.25 | $288.40 |
United Setting Professional Modifier None Typical Low $107.15 Median $120.23 Typical High $181.97 | Professional | None | $107.15 | $120.23 | $181.97 |
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 $61.66 Median $63.10 Typical High $64.57 | Professional | 52 · Reduced service | $61.66 | $63.10 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $25.12 Typical High $25.70 | Professional | 53 · Discontinued | $24.55 | $25.12 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $19.05 Typical High $19.05 | Professional | 55 · Aftercare only | $18.62 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.59 Typical High $12.88 | Professional | 56 · Pre-op care only | $12.30 | $12.59 | $12.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $13.18 Median $13.18 Typical High $16.98 | Professional | RR · Rental | $13.18 | $13.18 | $16.98 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $95.50 Median $97.72 Typical High $102.33 | Professional | UE · Used equipment | $95.50 | $97.72 | $102.33 |
Where Virginia sits
The same service costs 2.8 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
$129
HI $331DE $120
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.