How much rates vary
Facilitymedian $7,413 · 10th to 90th $407 to $17,783Professionalmedian $1,622 · 10th to 90th $355 to $2,818
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 $501.19 Median $4,073.80 Typical High $9,332.54 | Facility | None | $501.19 | $4,073.80 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $1,584.89 Typical High $3,235.94 | Professional | None | $398.11 | $1,584.89 | $3,235.94 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $7,413.10 Typical High $9,549.93 | Facility | None | $6,165.95 | $7,413.10 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $354.81 Median $1,584.89 Typical High $2,630.27 | Professional | None | $354.81 | $1,584.89 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $537.03 Median $2,398.83 Typical High $3,801.89 | Professional | 50 · Both sides | $537.03 | $2,398.83 | $3,801.89 |
CareFirst Setting Professional Modifier None Typical Low $354.81 Median $398.11 Typical High $467.74 | Professional | None | $354.81 | $398.11 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $954.99 Typical High $3,019.95 | Professional | None | $346.74 | $954.99 | $3,019.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,238.72 Median $2,691.53 Typical High $3,311.31 | Professional | None | $2,238.72 | $2,691.53 | $3,311.31 |
Medcost Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $4,897.79 | Professional | None | $4,897.79 | $4,897.79 | $4,897.79 |
Medcost Setting Facility Modifier None Typical Low $457.09 Median $660.69 Typical High $3,467.37 | Facility | None | $457.09 | $660.69 | $3,467.37 |
Medcost Setting Professional Modifier None Typical Low $1,819.70 Median $2,290.87 Typical High $2,818.38 | Professional | None | $1,819.70 | $2,290.87 | $2,818.38 |
Sentara Setting Facility Modifier None Typical Low $309.03 Median $676.08 Typical High $12,022.64 | Facility | None | $309.03 | $676.08 | $12,022.64 |
Sentara Setting Professional Modifier None Typical Low $1,905.46 Median $2,290.87 Typical High $5,248.07 | Professional | None | $1,905.46 | $2,290.87 | $5,248.07 |
United Setting Facility Modifier None Typical Low $9,549.93 Median $13,182.57 Typical High $30,902.95 | Facility | None | $9,549.93 | $13,182.57 | $30,902.95 |
United Setting Professional Modifier None Typical Low $331.13 Median $1,513.56 Typical High $3,388.44 | Professional | None | $331.13 | $1,513.56 | $3,388.44 |
5 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 $199.53 Median $323.59 Typical High $1,348.96 | Professional | 52 · Reduced service | $199.53 | $323.59 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $128.82 Typical High $537.03 | Professional | 53 · Discontinued | $81.28 | $128.82 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $489.78 Typical High $1,995.26 | Professional | 54 · Surgery only | $302.00 | $489.78 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $97.72 Typical High $407.38 | Professional | 55 · Aftercare only | $60.26 | $97.72 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $64.57 Typical High $269.15 | Professional | 56 · Pre-op care only | $39.81 | $64.57 | $269.15 |
Where Virginia sits
The same service costs 6.2 times more in Washington than in Maryland. 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· 31st of 51
$1,738
WA $3,162MD $513
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.