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 $85.11 Median $89.13 Typical High $162.18 | Facility | None | $85.11 | $89.13 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $89.13 | Professional | None | $85.11 | $85.11 | $89.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $81.28 Median $173.78 Typical High $281.84 | Facility | None | $81.28 | $173.78 | $281.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
CareFirst Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $173.78 Typical High $223.87 | Facility | None | $125.89 | $173.78 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $72.44 Median $85.11 Typical High $97.72 | Professional | None | $72.44 | $85.11 | $97.72 |
Medcost Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $138.04 | Facility | None | $81.28 | $81.28 | $138.04 |
Medcost Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $97.72 | Professional | None | $72.44 | $72.44 | $97.72 |
Sentara Setting Facility Modifier None Typical Low $77.62 Median $87.10 Typical High $112.20 | Facility | None | $77.62 | $87.10 | $112.20 |
Sentara Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $93.33 | Professional | None | $85.11 | $85.11 | $93.33 |
United Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
United Setting Professional Modifier None Typical Low $81.28 Median $87.10 Typical High $91.20 | Professional | None | $81.28 | $87.10 | $91.20 |
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 $42.66 Median $42.66 Typical High $44.67 | Professional | 52 · Reduced service | $42.66 | $42.66 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $18.20 | Professional | 53 · Discontinued | $16.98 | $16.98 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $12.88 Typical High $13.49 | Professional | 55 · Aftercare only | $12.88 | $12.88 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $8.91 | Professional | 56 · Pre-op care only | $8.51 | $8.51 | $8.91 |
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· 45th of 51
$85.11
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.