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 $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $229.09 Typical High $229.09 | Professional | None | $223.87 | $229.09 | $229.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $467.74 | Facility | None | $436.52 | $436.52 | $467.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $302.00 | Professional | None | $245.47 | $245.47 | $302.00 |
CareFirst Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $302.00 | Professional | None | $234.42 | $234.42 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $302.00 Typical High $302.00 | Facility | None | $199.53 | $302.00 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $302.00 | Professional | None | $218.78 | $218.78 | $302.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $309.03 Median $436.52 Typical High $575.44 | Professional | None | $309.03 | $436.52 | $575.44 |
Medcost Setting Professional Modifier None Typical Low $257.04 Median $288.40 Typical High $407.38 | Professional | None | $257.04 | $288.40 | $407.38 |
Medcost Setting Facility Modifier None Typical Low $144.54 Median $234.42 Typical High $288.40 | Facility | None | $144.54 | $234.42 | $288.40 |
Medcost Setting Professional Modifier None Typical Low $213.80 Median $234.42 Typical High $288.40 | Professional | None | $213.80 | $234.42 | $288.40 |
Sentara Setting Facility Modifier None Typical Low $213.80 Median $302.00 Typical High $954.99 | Facility | None | $213.80 | $302.00 | $954.99 |
Sentara Setting Professional Modifier None Typical Low $234.42 Median $323.59 Typical High $660.69 | Professional | None | $234.42 | $323.59 | $660.69 |
United Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $660.69 | Facility | None | $251.19 | $251.19 | $660.69 |
United Setting Professional Modifier None Typical Low $199.53 Median $213.80 Typical High $323.59 | Professional | None | $199.53 | $213.80 | $323.59 |
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 $114.82 Median $114.82 Typical High $114.82 | Professional | 52 · Reduced service | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | 53 · Discontinued | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $34.67 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $22.91 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $24.55 Median $24.55 Typical High $33.11 | Professional | RR · Rental | $24.55 | $24.55 | $33.11 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $181.97 Median $181.97 Typical High $199.53 | Professional | UE · Used equipment | $181.97 | $181.97 | $199.53 |
Where Virginia sits
The same service costs 2.5 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· 37th of 51
$245
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.