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 $8.32 Median $63.10 Typical High $81.28 | Facility | None | $8.32 | $63.10 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $66.07 | Professional | None | $63.10 | $63.10 | $66.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
CareFirst Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $117.49 Typical High $162.18 | Facility | None | $91.20 | $117.49 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Kaiser Permanente Setting Professional Modifier None Typical Low $53.70 Median $63.10 Typical High $75.86 | Professional | None | $53.70 | $63.10 | $75.86 |
Medcost Setting Professional Modifier None Typical Low $4.47 Median $4.79 Typical High $4.79 | Professional | None | $4.47 | $4.79 | $4.79 |
Medcost Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $66.07 | Facility | None | $57.54 | $57.54 | $66.07 |
Medcost Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $57.54 | Professional | None | $2.00 | $2.00 | $57.54 |
Sentara Setting Facility Modifier None Typical Low $63.10 Median $70.79 Typical High $83.18 | Facility | None | $63.10 | $70.79 | $83.18 |
Sentara Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $75.86 | Professional | None | $63.10 | $63.10 | $75.86 |
United Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $58.88 | Professional | None | $57.54 | $57.54 | $58.88 |
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 $31.62 Median $31.62 Typical High $33.11 | Professional | 52 · Reduced service | $31.62 | $31.62 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $12.59 Typical High $13.18 | Professional | 53 · Discontinued | $12.59 | $12.59 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.33 Typical High $10.00 | Professional | 55 · Aftercare only | $9.33 | $9.33 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.31 Typical High $6.61 | Professional | 56 · Pre-op care only | $6.31 | $6.31 | $6.61 |
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· 42nd of 51
$63.10
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.