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 $1,348.96 Median $1,348.96 Typical High $1,348.96 | Facility | None | $1,348.96 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,288.25 | $1,348.96 | $1,348.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,548.13 | Professional | None | $3,019.95 | $3,019.95 | $3,548.13 |
CareFirst Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,778.28 | Professional | None | $1,737.80 | $1,737.80 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $977.24 Median $1,479.11 Typical High $1,479.11 | Facility | None | $977.24 | $1,479.11 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,479.11 | Professional | None | $1,258.93 | $1,258.93 | $1,479.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,819.70 Median $2,630.27 Typical High $3,388.44 | Professional | None | $1,819.70 | $2,630.27 | $3,388.44 |
Medcost Setting Professional Modifier None Typical Low $1,318.26 Median $1,698.24 Typical High $2,398.83 | Professional | None | $1,318.26 | $1,698.24 | $2,398.83 |
Medcost Setting Facility Modifier None Typical Low $831.76 Median $1,412.54 Typical High $1,698.24 | Facility | None | $831.76 | $1,412.54 | $1,698.24 |
Medcost Setting Professional Modifier None Typical Low $1,412.54 Median $1,513.56 Typical High $1,698.24 | Professional | None | $1,412.54 | $1,513.56 | $1,698.24 |
Sentara Setting Facility Modifier None Typical Low $1,258.93 Median $1,819.70 Typical High $4,073.80 | Facility | None | $1,258.93 | $1,819.70 | $4,073.80 |
Sentara Setting Professional Modifier None Typical Low $1,318.26 Median $1,905.46 Typical High $3,548.13 | Professional | None | $1,318.26 | $1,905.46 | $3,548.13 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,288.25 Typical High $1,905.46 | Professional | None | $1,174.90 | $1,288.25 | $1,905.46 |
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 $645.65 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $645.65 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $269.15 Typical High $275.42 | Professional | 53 · Discontinued | $257.04 | $269.15 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $194.98 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $128.82 | $134.90 | $134.90 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $85.11 Median $190.55 Typical High $223.87 | Professional | RR · Rental | $85.11 | $190.55 | $223.87 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $645.65 Median $1,412.54 Typical High $1,698.24 | Professional | UE · Used equipment | $645.65 | $1,412.54 | $1,698.24 |
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· 20th of 51
$1,738
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.