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 $1,905.46 Median $2,454.71 Typical High $5,370.32 | Facility | None | $1,905.46 | $2,454.71 | $5,370.32 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,995.26 | Professional | None | $1,905.46 | $1,905.46 | $1,995.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $3,890.45 Typical High $6,165.95 | Facility | None | $1,862.09 | $3,890.45 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,621.81 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,621.81 | $1,905.46 | $1,905.46 |
CareFirst Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,862.09 | Professional | None | $1,737.80 | $1,737.80 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $2,754.23 Median $3,630.78 Typical High $4,897.79 | Facility | None | $2,754.23 | $3,630.78 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,905.46 | $1,905.46 | $1,905.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,621.81 Median $1,995.26 Typical High $3,801.89 | Professional | None | $1,621.81 | $1,995.26 | $3,801.89 |
Medcost Setting Facility Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $5,888.44 | Facility | None | $1,862.09 | $1,862.09 | $5,888.44 |
Sentara Setting Facility Modifier None Typical Low $1,949.84 Median $3,388.44 Typical High $3,630.78 | Facility | None | $1,949.84 | $3,388.44 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $1,949.84 Median $3,388.44 Typical High $3,630.78 | Professional | None | $1,949.84 | $3,388.44 | $3,630.78 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Facility | None | $1,905.46 | $1,905.46 | $1,905.46 |
United Setting Professional Modifier None Typical Low $1,778.28 Median $1,862.09 Typical High $1,949.84 | Professional | None | $1,778.28 | $1,862.09 | $1,949.84 |
4 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 $954.99 Median $954.99 Typical High $1,000.00 | Professional | 52 · Reduced service | $954.99 | $954.99 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $389.05 Typical High $398.11 | Professional | 53 · Discontinued | $380.19 | $389.05 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $288.40 Typical High $302.00 | Professional | 55 · Aftercare only | $288.40 | $288.40 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $190.55 Typical High $199.53 | Professional | 56 · Pre-op care only | $190.55 | $190.55 | $199.53 |
Where Virginia sits
The same service costs 2.3 times more in Texas 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· 34th of 51
$1,905
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.