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 $138.04 Median $138.04 Typical High $316.23 | Facility | None | $138.04 | $138.04 | $316.23 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $363.08 | Professional | None | $302.00 | $302.00 | $363.08 |
CareFirst Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $181.97 | Professional | None | $144.54 | $144.54 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $194.98 Typical High $194.98 | Facility | None | $97.72 | $194.98 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $194.98 | Professional | None | $165.96 | $165.96 | $194.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $186.21 Median $269.15 Typical High $346.74 | Professional | None | $186.21 | $269.15 | $346.74 |
Medcost Setting Professional Modifier None Typical Low $158.49 Median $173.78 Typical High $245.47 | Professional | None | $158.49 | $173.78 | $245.47 |
Medcost Setting Facility Modifier None Typical Low $83.18 Median $144.54 Typical High $173.78 | Facility | None | $83.18 | $144.54 | $173.78 |
Medcost Setting Professional Modifier None Typical Low $144.54 Median $154.88 Typical High $181.97 | Professional | None | $144.54 | $154.88 | $181.97 |
Sentara Setting Facility Modifier None Typical Low $128.82 Median $186.21 Typical High $416.87 | Facility | None | $128.82 | $186.21 | $416.87 |
Sentara Setting Professional Modifier None Typical Low $138.04 Median $194.98 Typical High $363.08 | Professional | None | $138.04 | $194.98 | $363.08 |
United Setting Professional Modifier None Typical Low $117.49 Median $131.83 Typical High $194.98 | Professional | None | $117.49 | $131.83 | $194.98 |
3 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 $19.05 Median $20.89 Typical High $20.89 | Professional | 55 · Aftercare only | $19.05 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $13.80 Typical High $13.80 | Professional | 56 · Pre-op care only | $12.88 | $13.80 | $13.80 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $64.57 Median $141.25 Typical High $173.78 | Professional | UE · Used equipment | $64.57 | $141.25 | $173.78 |
Where Virginia sits
The same service costs 2.6 times more in Montana than in New York. 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· 21st of 51
$182
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.