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 $691.83 Median $691.83 Typical High $724.44 | Facility | None | $691.83 | $691.83 | $724.44 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $724.44 | Professional | None | $691.83 | $691.83 | $724.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $1,380.38 Typical High $2,238.72 | Facility | None | $691.83 | $1,380.38 | $2,238.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
CareFirst Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $1,380.38 Typical High $1,778.28 | Facility | None | $1,000.00 | $1,380.38 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $588.84 Median $691.83 Typical High $776.25 | Professional | None | $588.84 | $691.83 | $776.25 |
Medcost Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $1,096.48 | Facility | None | $691.83 | $691.83 | $1,096.48 |
Medcost Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $776.25 | Professional | None | $489.78 | $489.78 | $776.25 |
Sentara Setting Facility Modifier None Typical Low $630.96 Median $707.95 Typical High $891.25 | Facility | None | $630.96 | $707.95 | $891.25 |
Sentara Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $741.31 | Professional | None | $691.83 | $691.83 | $741.31 |
United Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Facility | None | $691.83 | $691.83 | $691.83 |
United Setting Professional Modifier None Typical Low $691.83 Median $724.44 Typical High $776.25 | Professional | None | $691.83 | $724.44 | $776.25 |
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 $338.84 Median $338.84 Typical High $363.08 | Professional | 52 · Reduced service | $338.84 | $338.84 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $144.54 | Professional | 53 · Discontinued | $138.04 | $138.04 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $107.15 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $72.44 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $72.44 |
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· 32nd of 51
$692
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.