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 $2.19 Median $2.82 Typical High $4.07 | Facility | None | $2.19 | $2.82 | $4.07 |
Aetna Setting Professional Modifier None Typical Low $2.19 Median $2.45 Typical High $3.24 | Professional | None | $2.19 | $2.45 | $3.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.86 Median $2.19 Typical High $2.19 | Professional | None | $1.86 | $2.19 | $2.19 |
CareFirst Setting Professional Modifier None Typical Low $2.00 Median $2.29 Typical High $2.29 | Professional | None | $2.00 | $2.29 | $2.29 |
Cigna Setting Facility Modifier None Typical Low $3.24 Median $4.07 Typical High $5.62 | Facility | None | $3.24 | $4.07 | $5.62 |
Cigna Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | None | $2.19 | $2.19 | $2.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.86 Median $2.29 Typical High $8.71 | Professional | None | $1.86 | $2.29 | $8.71 |
Medcost Setting Professional Modifier None Typical Low $5.89 Median $5.89 Typical High $5.89 | Professional | None | $5.89 | $5.89 | $5.89 |
Medcost Setting Facility Modifier None Typical Low $2.09 Median $2.09 Typical High $6.46 | Facility | None | $2.09 | $2.09 | $6.46 |
Sentara Setting Facility Modifier None Typical Low $1.91 Median $2.24 Typical High $2.88 | Facility | None | $1.91 | $2.24 | $2.88 |
Sentara Setting Professional Modifier None Typical Low $1.91 Median $2.24 Typical High $2.88 | Professional | None | $1.91 | $2.24 | $2.88 |
United Setting Professional Modifier None Typical Low $1.95 Median $2.04 Typical High $2.14 | Professional | None | $1.95 | $2.04 | $2.14 |
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 $1.10 Median $1.12 Typical High $1.15 | Professional | 52 · Reduced service | $1.10 | $1.12 | $1.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.44 Median $0.44 Typical High $0.46 | Professional | 53 · Discontinued | $0.44 | $0.44 | $0.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.33 Median $0.33 Typical High $0.35 | Professional | 55 · Aftercare only | $0.33 | $0.33 | $0.35 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.22 Typical High $0.23 | Professional | 56 · Pre-op care only | $0.22 | $0.22 | $0.23 |
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· 41st of 51
$2.19
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.