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 $5,248.07 Median $5,248.07 Typical High $5,248.07 | Facility | None | $5,248.07 | $5,248.07 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $5,011.87 Median $5,248.07 Typical High $5,248.07 | Professional | None | $5,011.87 | $5,248.07 | $5,248.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $4,168.69 Median $6,606.93 Typical High $8,511.38 | Professional | None | $4,168.69 | $6,606.93 | $8,511.38 |
CareFirst Setting Professional Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $6,918.31 | Professional | None | $5,495.41 | $5,495.41 | $6,918.31 |
Cigna Setting Facility Modifier None Typical Low $3,801.89 Median $5,623.41 Typical High $5,623.41 | Facility | None | $3,801.89 | $5,623.41 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $5,623.41 | Professional | None | $4,786.30 | $4,786.30 | $5,623.41 |
Kaiser Permanente Setting Professional Modifier None Typical Low $7,079.46 Median $10,000.00 Typical High $13,182.57 | Professional | None | $7,079.46 | $10,000.00 | $13,182.57 |
Medcost Setting Facility Modifier None Typical Low $5,370.32 Median $5,370.32 Typical High $7,413.10 | Facility | None | $5,370.32 | $5,370.32 | $7,413.10 |
Medcost Setting Professional Modifier None Typical Low $5,370.32 Median $6,025.60 Typical High $7,943.28 | Professional | None | $5,370.32 | $6,025.60 | $7,943.28 |
Sentara Setting Facility Modifier None Typical Low $5,495.41 Median $7,762.47 Typical High $15,488.17 | Facility | None | $5,495.41 | $7,762.47 | $15,488.17 |
Sentara Setting Professional Modifier None Typical Low $5,370.32 Median $7,762.47 Typical High $13,489.63 | Professional | None | $5,370.32 | $7,762.47 | $13,489.63 |
United Setting Professional Modifier None Typical Low $4,677.35 Median $4,897.79 Typical High $7,762.47 | Professional | None | $4,677.35 | $4,897.79 | $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 $2,511.89 Median $2,630.27 Typical High $2,630.27 | Professional | 52 · Reduced service | $2,511.89 | $2,630.27 | $2,630.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,000.00 Median $1,047.13 Typical High $1,047.13 | Professional | 53 · Discontinued | $1,000.00 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $758.58 Median $776.25 Typical High $794.33 | Professional | 55 · Aftercare only | $758.58 | $776.25 | $794.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $501.19 Median $524.81 Typical High $524.81 | Professional | 56 · Pre-op care only | $501.19 | $524.81 | $524.81 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $288.40 Median $724.44 Typical High $851.14 | Professional | RR · Rental | $288.40 | $724.44 | $851.14 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2,187.76 Median $5,370.32 Typical High $6,309.57 | Professional | UE · Used equipment | $2,187.76 | $5,370.32 | $6,309.57 |
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· 34th of 51
$5,495
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.