How much rates vary
Facilitymedian $4,365 · 10th to 90th $2,455 to $7,413Professionalmedian $2,570 · 10th to 90th $2,455 to $2,692
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 $2,570.40 Median $2,570.40 Typical High $2,691.53 | Facility | None | $2,570.40 | $2,570.40 | $2,691.53 |
Aetna Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,691.53 | Professional | None | $2,570.40 | $2,570.40 | $2,691.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,454.71 Median $5,128.61 Typical High $8,317.64 | Facility | None | $2,454.71 | $5,128.61 | $8,317.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,570.40 | $2,570.40 | $2,570.40 |
CareFirst Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $3,715.35 Median $4,786.30 Typical High $6,606.93 | Facility | None | $3,715.35 | $4,786.30 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,570.40 | $2,570.40 | $2,570.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,187.76 Median $2,570.40 Typical High $2,951.21 | Professional | None | $2,187.76 | $2,570.40 | $2,951.21 |
Medcost Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $3,467.37 | Facility | None | $2,454.71 | $2,454.71 | $3,467.37 |
Medcost Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $2,951.21 | Professional | None | $1,737.80 | $1,737.80 | $2,951.21 |
Sentara Setting Facility Modifier None Typical Low $2,398.83 Median $2,570.40 Typical High $3,311.31 | Facility | None | $2,398.83 | $2,570.40 | $3,311.31 |
Sentara Setting Professional Modifier None Typical Low $2,511.89 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,511.89 | $2,570.40 | $2,570.40 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Facility | None | $2,570.40 | $2,570.40 | $2,570.40 |
United Setting Professional Modifier None Typical Low $2,454.71 Median $2,570.40 Typical High $2,754.23 | Professional | None | $2,454.71 | $2,570.40 | $2,754.23 |
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 $1,258.93 Median $1,258.93 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,258.93 | $1,258.93 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $512.86 Typical High $537.03 | Professional | 53 · Discontinued | $512.86 | $512.86 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $1,905.46 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,905.46 | $1,905.46 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $380.19 Typical High $398.11 | Professional | 55 · Aftercare only | $380.19 | $380.19 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $257.04 Typical High $269.15 | Professional | 56 · Pre-op care only | $257.04 | $257.04 | $269.15 |
Where Virginia sits
Rates are fairly even across states for this service. 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· 22nd of 51
$2,570
AK $3,020KS $2,570
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.