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 $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $912.01 | Facility | None | $851.14 | $851.14 | $912.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $575.44 | Professional | None | $512.86 | $512.86 | $575.44 |
CareFirst Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $588.84 | Professional | None | $512.86 | $512.86 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $524.81 Typical High $524.81 | Facility | None | $407.38 | $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 $602.56 Median $851.14 Typical High $1,122.02 | Professional | None | $602.56 | $851.14 | $1,122.02 |
Medcost Setting Professional Modifier None Typical Low $436.52 Median $575.44 Typical High $575.44 | Professional | None | $436.52 | $575.44 | $575.44 |
Medcost Setting Facility Modifier None Typical Low $281.84 Median $457.09 Typical High $562.34 | Facility | None | $281.84 | $457.09 | $562.34 |
Medcost Setting Professional Modifier None Typical Low $457.09 Median $501.19 Typical High $630.96 | Professional | None | $457.09 | $501.19 | $630.96 |
Sentara Setting Facility Modifier None Typical Low $407.38 Median $645.65 Typical High $3,090.30 | Facility | None | $407.38 | $645.65 | $3,090.30 |
Sentara Setting Professional Modifier None Typical Low $436.52 Median $660.69 Typical High $1,348.96 | Professional | None | $436.52 | $660.69 | $1,348.96 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,318.26 | Facility | None | $1,096.48 | $1,096.48 | $1,318.26 |
United Setting Professional Modifier None Typical Low $389.05 Median $416.87 Typical High $630.96 | Professional | None | $389.05 | $416.87 | $630.96 |
4 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 55 · Aftercare only Typical Low $66.07 Median $66.07 Typical High $67.61 | Professional | 55 · Aftercare only | $66.07 | $66.07 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $44.67 | $44.67 | $44.67 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $52.48 Median $52.48 Typical High $63.10 | Professional | RR · Rental | $52.48 | $52.48 | $63.10 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $380.19 Median $398.11 Typical High $416.87 | Professional | UE · Used equipment | $380.19 | $398.11 | $416.87 |
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· 39th of 51
$513
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.