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 $2.09 Median $8.13 Typical High $13.80 | Facility | None | $2.09 | $8.13 | $13.80 |
Aetna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.51 | Professional | None | $8.13 | $8.13 | $8.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
CareFirst Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | None | $7.24 | $7.24 | $7.24 |
Cigna Setting Facility Modifier None Typical Low $11.75 Median $15.49 Typical High $20.89 | Facility | None | $11.75 | $15.49 | $20.89 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $6.92 Median $8.13 Typical High $10.96 | Professional | None | $6.92 | $8.13 | $10.96 |
Medcost Setting Professional Modifier None Typical Low $1.17 Median $1.17 Typical High $3.72 | Professional | None | $1.17 | $1.17 | $3.72 |
Medcost Setting Facility Modifier None Typical Low $10.23 Median $10.23 Typical High $12.88 | Facility | None | $10.23 | $10.23 | $12.88 |
Medcost Setting Professional Modifier None Typical Low $1.82 Median $3.98 Typical High $9.55 | Professional | None | $1.82 | $3.98 | $9.55 |
Sentara Setting Facility Modifier None Typical Low $8.32 Median $10.23 Typical High $10.96 | Facility | None | $8.32 | $10.23 | $10.96 |
Sentara Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $10.96 | Professional | None | $8.13 | $8.13 | $10.96 |
United Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | None | $7.24 | $7.24 | $7.24 |
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 $4.07 Median $4.07 Typical High $4.27 | Professional | 52 · Reduced service | $4.07 | $4.07 | $4.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.62 Median $1.62 Typical High $1.70 | Professional | 53 · Discontinued | $1.62 | $1.62 | $1.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $1.23 Typical High $1.29 | Professional | 55 · Aftercare only | $1.23 | $1.23 | $1.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $0.81 Typical High $0.85 | Professional | 56 · Pre-op care only | $0.81 | $0.81 | $0.85 |
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
$8.13
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.