How much rates vary
Facilitymedian $7,586 · 10th to 90th $4,786 to $11,482Professionalmedian $6,607 · 10th to 90th $5,129 to $8,913
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 $5,495.41 Median $5,495.41 Typical High $5,495.41 | Facility | None | $5,495.41 | $5,495.41 | $5,495.41 |
Aetna Setting Professional Modifier None Typical Low $5,248.07 Median $5,495.41 Typical High $5,495.41 | Professional | None | $5,248.07 | $5,495.41 | $5,495.41 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,471.29 Median $10,471.29 Typical High $11,220.18 | Facility | None | $10,471.29 | $10,471.29 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $7,413.10 | Professional | None | $6,606.93 | $6,606.93 | $7,413.10 |
CareFirst Setting Professional Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $7,244.36 | Professional | None | $5,495.41 | $5,495.41 | $7,244.36 |
Cigna Setting Facility Modifier None Typical Low $4,677.35 Median $7,585.78 Typical High $7,585.78 | Facility | None | $4,677.35 | $7,585.78 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $7,585.78 | Professional | None | $5,495.41 | $5,495.41 | $7,585.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $7,413.10 Median $10,471.29 Typical High $13,803.84 | Professional | None | $7,413.10 | $10,471.29 | $13,803.84 |
Medcost Setting Professional Modifier None Typical Low $6,165.95 Median $6,918.31 Typical High $9,772.37 | Professional | None | $6,165.95 | $6,918.31 | $9,772.37 |
Medcost Setting Facility Modifier None Typical Low $3,311.31 Median $5,623.41 Typical High $6,918.31 | Facility | None | $3,311.31 | $5,623.41 | $6,918.31 |
Medcost Setting Professional Modifier None Typical Low $4,168.69 Median $5,623.41 Typical High $6,918.31 | Professional | None | $4,168.69 | $5,623.41 | $6,918.31 |
Sentara Setting Facility Modifier None Typical Low $5,128.61 Median $7,413.10 Typical High $15,848.93 | Facility | None | $5,128.61 | $7,413.10 | $15,848.93 |
Sentara Setting Professional Modifier None Typical Low $5,623.41 Median $7,943.28 Typical High $14,125.38 | Professional | None | $5,623.41 | $7,943.28 | $14,125.38 |
United Setting Facility Modifier None Typical Low $4,265.80 Median $4,786.30 Typical High $12,882.50 | Facility | None | $4,265.80 | $4,786.30 | $12,882.50 |
United Setting Professional Modifier None Typical Low $4,677.35 Median $5,128.61 Typical High $7,762.47 | Professional | None | $4,677.35 | $5,128.61 | $7,762.47 |
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 $2,630.27 Median $2,754.23 Typical High $2,754.23 | Professional | 52 · Reduced service | $2,630.27 | $2,754.23 | $2,754.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,047.13 Median $1,096.48 Typical High $1,096.48 | Professional | 53 · Discontinued | $1,047.13 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $794.33 Median $812.83 Typical High $831.76 | Professional | 55 · Aftercare only | $794.33 | $812.83 | $831.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $524.81 Median $549.54 Typical High $549.54 | Professional | 56 · Pre-op care only | $524.81 | $549.54 | $549.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $676.08 Median $676.08 Typical High $758.58 | Professional | RR · Rental | $676.08 | $676.08 | $758.58 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4,897.79 Median $5,011.87 Typical High $5,248.07 | Professional | UE · Used equipment | $4,897.79 | $5,011.87 | $5,248.07 |
Where Virginia sits
The same service costs 2.1 times more in Montana 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· 33rd of 51
$6,607
MT $11,220PA $5,370
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.