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 $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $758.58 | Facility | None | $724.44 | $724.44 | $758.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $478.63 | Professional | None | $426.58 | $426.58 | $478.63 |
CareFirst Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $489.78 | Professional | None | $426.58 | $426.58 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $562.34 Typical High $562.34 | Facility | None | $338.84 | $562.34 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $562.34 | Professional | None | $407.38 | $407.38 | $562.34 |
Kaiser Permanente Setting Professional Modifier None Typical Low $501.19 Median $724.44 Typical High $933.25 | Professional | None | $501.19 | $724.44 | $933.25 |
Medcost Setting Professional Modifier None Typical Low $363.08 Median $478.63 Typical High $478.63 | Professional | None | $363.08 | $478.63 | $478.63 |
Medcost Setting Facility Modifier None Typical Low $234.42 Median $389.05 Typical High $467.74 | Facility | None | $234.42 | $389.05 | $467.74 |
Medcost Setting Professional Modifier None Typical Low $389.05 Median $416.87 Typical High $524.81 | Professional | None | $389.05 | $416.87 | $524.81 |
Sentara Setting Facility Modifier None Typical Low $338.84 Median $537.03 Typical High $2,570.40 | Facility | None | $338.84 | $537.03 | $2,570.40 |
Sentara Setting Professional Modifier None Typical Low $363.08 Median $562.34 Typical High $1,174.90 | Professional | None | $363.08 | $562.34 | $1,174.90 |
United Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $1,096.48 | Facility | None | $912.01 | $912.01 | $1,096.48 |
United Setting Professional Modifier None Typical Low $323.59 Median $346.74 Typical High $524.81 | Professional | None | $323.59 | $346.74 | $524.81 |
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 $54.95 Median $54.95 Typical High $56.23 | Professional | 55 · Aftercare only | $54.95 | $54.95 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $37.15 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $43.65 Median $43.65 Typical High $53.70 | Professional | RR · Rental | $43.65 | $43.65 | $53.70 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $316.23 Median $331.13 Typical High $346.74 | Professional | UE · Used equipment | $316.23 | $331.13 | $346.74 |
Where Virginia sits
The same service costs 2.6 times more in Hawaii than in New Jersey. 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
$427
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.