How much rates vary
Facilitymedian $525 · 10th to 90th $355 to $1,023Professionalmedian $407 · 10th to 90th $331 to $562
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 $354.81 Median $354.81 Typical High $354.81 | Facility | None | $354.81 | $354.81 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $724.44 | Facility | None | $676.08 | $676.08 | $724.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $467.74 | Professional | None | $407.38 | $407.38 | $467.74 |
CareFirst Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $467.74 | Professional | None | $363.08 | $363.08 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $524.81 Typical High $524.81 | Facility | None | $331.13 | $524.81 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $524.81 | Professional | None | $389.05 | $389.05 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $478.63 Median $676.08 Typical High $891.25 | Professional | None | $478.63 | $676.08 | $891.25 |
Medcost Setting Professional Modifier None Typical Low $407.38 Median $446.68 Typical High $630.96 | Professional | None | $407.38 | $446.68 | $630.96 |
Medcost Setting Facility Modifier None Typical Low $223.87 Median $363.08 Typical High $446.68 | Facility | None | $223.87 | $363.08 | $446.68 |
Medcost Setting Professional Modifier None Typical Low $295.12 Median $389.05 Typical High $446.68 | Professional | None | $295.12 | $389.05 | $446.68 |
Sentara Setting Facility Modifier None Typical Low $331.13 Median $467.74 Typical High $1,479.11 | Facility | None | $331.13 | $467.74 | $1,479.11 |
Sentara Setting Professional Modifier None Typical Low $363.08 Median $501.19 Typical High $1,023.29 | Professional | None | $363.08 | $501.19 | $1,023.29 |
United Setting Facility Modifier None Typical Low $302.00 Median $380.19 Typical High $870.96 | Facility | None | $302.00 | $380.19 | $870.96 |
United Setting Professional Modifier None Typical Low $309.03 Median $331.13 Typical High $501.19 | Professional | None | $309.03 | $331.13 | $501.19 |
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 $177.83 Median $177.83 Typical High $177.83 | Professional | 52 · Reduced service | $177.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | 53 · Discontinued | $70.79 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $53.70 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $35.48 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $42.66 Median $42.66 Typical High $51.29 | Professional | RR · Rental | $42.66 | $42.66 | $51.29 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $309.03 Median $316.23 Typical High $331.13 | Professional | UE · Used equipment | $309.03 | $316.23 | $331.13 |
Where Virginia sits
The same service costs 2.3 times more in Hawaii than in Pennsylvania. 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· 36th of 51
$407
HI $851PA $363
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.