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 $263.03 Median $295.12 Typical High $524.81 | Facility | None | $263.03 | $295.12 | $524.81 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $295.12 | Professional | None | $281.84 | $281.84 | $295.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $269.15 Median $562.34 Typical High $912.01 | Facility | None | $269.15 | $562.34 | $912.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
CareFirst Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $562.34 Typical High $724.44 | Facility | None | $407.38 | $562.34 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $239.88 Median $281.84 Typical High $331.13 | Professional | None | $239.88 | $281.84 | $331.13 |
Medcost Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
Medcost Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $295.12 | Facility | None | $275.42 | $275.42 | $295.12 |
Medcost Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $316.23 | Professional | None | $100.00 | $100.00 | $316.23 |
Sentara Setting Facility Modifier None Typical Low $251.19 Median $288.40 Typical High $363.08 | Facility | None | $251.19 | $288.40 | $363.08 |
Sentara Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $302.00 | Professional | None | $281.84 | $281.84 | $302.00 |
United Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
United Setting Professional Modifier None Typical Low $269.15 Median $281.84 Typical High $302.00 | Professional | None | $269.15 | $281.84 | $302.00 |
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 $138.04 Median $138.04 Typical High $147.91 | Professional | 52 · Reduced service | $138.04 | $138.04 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $56.23 Typical High $58.88 | Professional | 53 · Discontinued | $56.23 | $56.23 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $41.69 Typical High $43.65 | Professional | 55 · Aftercare only | $41.69 | $41.69 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $29.51 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $29.51 |
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· 34th of 51
$282
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.