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 $173.78 Median $194.98 Typical High $323.59 | Facility | None | $173.78 | $194.98 | $323.59 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $181.97 | Professional | None | $173.78 | $173.78 | $181.97 |
Anthem BCBS Setting Facility Modifier None Typical Low $162.18 Median $354.81 Typical High $562.34 | Facility | None | $162.18 | $354.81 | $562.34 |
Anthem BCBS Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
CareFirst Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $354.81 Typical High $446.68 | Facility | None | $251.19 | $354.81 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $147.91 Median $173.78 Typical High $204.17 | Professional | None | $147.91 | $173.78 | $204.17 |
Medcost Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $204.17 | Facility | None | $162.18 | $162.18 | $204.17 |
Medcost Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $204.17 | Professional | None | $109.65 | $109.65 | $204.17 |
Sentara Setting Facility Modifier None Typical Low $162.18 Median $177.83 Typical High $229.09 | Facility | None | $162.18 | $177.83 | $229.09 |
Sentara Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $190.55 | Professional | None | $173.78 | $173.78 | $190.55 |
United Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
United Setting Professional Modifier None Typical Low $162.18 Median $173.78 Typical High $181.97 | Professional | None | $162.18 | $173.78 | $181.97 |
5 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 $87.10 Median $87.10 Typical High $91.20 | Professional | 52 · Reduced service | $87.10 | $87.10 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $34.67 Typical High $36.31 | Professional | 53 · Discontinued | $34.67 | $34.67 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $128.82 Typical High $134.90 | Professional | 54 · Surgery only | $128.82 | $128.82 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $27.54 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $18.20 | Professional | 56 · Pre-op care only | $17.38 | $17.38 | $18.20 |
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
$174
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.