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 $57.54 Median $60.26 Typical High $107.15 | Facility | None | $57.54 | $60.26 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $60.26 | Professional | None | $57.54 | $57.54 | $60.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $54.95 Median $114.82 Typical High $186.21 | Facility | None | $54.95 | $114.82 | $186.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
CareFirst Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $114.82 Typical High $147.91 | Facility | None | $83.18 | $114.82 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $48.98 Median $57.54 Typical High $69.18 | Professional | None | $48.98 | $57.54 | $69.18 |
Medcost Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $91.20 | Facility | None | $54.95 | $54.95 | $91.20 |
Medcost Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $74.13 | Professional | None | $45.71 | $45.71 | $74.13 |
Sentara Setting Facility Modifier None Typical Low $58.88 Median $66.07 Typical High $74.13 | Facility | None | $58.88 | $66.07 | $74.13 |
Sentara Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $70.79 | Professional | None | $57.54 | $57.54 | $70.79 |
United Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
United Setting Professional Modifier None Typical Low $54.95 Median $58.88 Typical High $61.66 | Professional | None | $54.95 | $58.88 | $61.66 |
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 $28.84 Median $28.84 Typical High $30.20 | Professional | 52 · Reduced service | $28.84 | $28.84 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $12.02 | Professional | 53 · Discontinued | $11.48 | $11.48 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $8.91 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.75 Typical High $6.03 | Professional | 56 · Pre-op care only | $5.75 | $5.75 | $6.03 |
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· 24th of 51
$57.54
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.