How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $5.75 Median $5.75 Typical High $10.96 | Facility | None | $5.75 | $5.75 | $10.96 |
Aetna Setting Professional Modifier None Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | None | $5.75 | $5.75 | $5.75 |
Anthem BCBS Setting Professional Modifier None Typical Low $66.07 Median $77.62 Typical High $85.11 | Professional | None | $66.07 | $77.62 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,174.90 Typical High $2,570.40 | Facility | None | $851.14 | $1,174.90 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
Medcost Setting Facility Modifier None Typical Low $8.91 Median $8.91 Typical High $8.91 | Facility | None | $8.91 | $8.91 | $8.91 |
Sentara Setting Facility Modifier None Typical Low $7,413.10 Median $10,232.93 Typical High $11,481.54 | Facility | None | $7,413.10 | $10,232.93 | $11,481.54 |
Sentara Setting Professional Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $4,570.88 | Professional | None | $4,570.88 | $4,570.88 | $4,570.88 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $1,445.44 Typical High $3,162.28 | Facility | None | $1,288.25 | $1,445.44 | $3,162.28 |
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 $2.88 Median $2.88 Typical High $2.88 | Professional | 52 · Reduced service | $2.88 | $2.88 | $2.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.15 Median $1.15 Typical High $1.15 | Professional | 53 · Discontinued | $1.15 | $1.15 | $1.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.87 Median $0.87 Typical High $0.87 | Professional | 55 · Aftercare only | $0.87 | $0.87 | $0.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.58 Median $0.58 Typical High $0.58 | Professional | 56 · Pre-op care only | $0.58 | $0.58 | $0.58 |
Where Virginia sits
The same service costs 190.5 times more in North Carolina than in North Dakota. 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· 39th of 51
$77.62
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.