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 $1,258.93 Median $1,258.93 Typical High $1,318.26 | Facility | None | $1,258.93 | $1,258.93 | $1,318.26 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,318.26 | Professional | None | $1,258.93 | $1,258.93 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,258.93 Median $2,570.40 Typical High $4,073.80 | Facility | None | $1,258.93 | $2,570.40 | $4,073.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
CareFirst Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $1,819.70 Median $2,511.89 Typical High $3,235.94 | Facility | None | $1,819.70 | $2,511.89 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $1,995.26 | Professional | None | $1,071.52 | $1,258.93 | $1,995.26 |
Medcost Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $741.31 | Professional | None | $691.83 | $691.83 | $741.31 |
Medcost Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $2,570.40 | Facility | None | $1,479.11 | $1,479.11 | $2,570.40 |
Medcost Setting Professional Modifier None Typical Low $575.44 Median $977.24 Typical High $1,479.11 | Professional | None | $575.44 | $977.24 | $1,479.11 |
Sentara Setting Facility Modifier None Typical Low $1,288.25 Median $1,445.44 Typical High $1,621.81 | Facility | None | $1,288.25 | $1,445.44 | $1,621.81 |
Sentara Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,445.44 | Professional | None | $1,258.93 | $1,258.93 | $1,445.44 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Facility | None | $1,258.93 | $1,258.93 | $1,258.93 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,348.96 Typical High $1,412.54 | Professional | None | $1,258.93 | $1,348.96 | $1,412.54 |
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 $616.60 Median $616.60 Typical High $660.69 | Professional | 52 · Reduced service | $616.60 | $616.60 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $263.03 | Professional | 53 · Discontinued | $251.19 | $251.19 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $194.98 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $131.83 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $131.83 |
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· 26th of 51
$1,259
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.