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 $36.31 Median $38.90 Typical High $69.18 | Facility | None | $36.31 | $38.90 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $38.90 | Professional | None | $36.31 | $36.31 | $38.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $36.31 Median $74.13 Typical High $120.23 | Facility | None | $36.31 | $74.13 | $120.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
CareFirst Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $74.13 Typical High $95.50 | Facility | None | $53.70 | $74.13 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $30.90 Median $36.31 Typical High $42.66 | Professional | None | $30.90 | $36.31 | $42.66 |
Medcost Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $58.88 | Facility | None | $36.31 | $36.31 | $58.88 |
Medcost Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $41.69 | Professional | None | $32.36 | $32.36 | $41.69 |
Sentara Setting Facility Modifier None Typical Low $33.88 Median $38.02 Typical High $47.86 | Facility | None | $33.88 | $38.02 | $47.86 |
Sentara Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $39.81 | Professional | None | $36.31 | $36.31 | $39.81 |
United Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
United Setting Professional Modifier None Typical Low $36.31 Median $38.90 Typical High $40.74 | Professional | None | $36.31 | $38.90 | $40.74 |
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 $18.20 Median $18.20 Typical High $19.05 | Professional | 52 · Reduced service | $18.20 | $18.20 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $7.41 Typical High $7.76 | Professional | 53 · Discontinued | $7.41 | $7.41 | $7.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $5.50 Typical High $5.75 | Professional | 55 · Aftercare only | $5.50 | $5.50 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.63 Typical High $3.89 | Professional | 56 · Pre-op care only | $3.63 | $3.63 | $3.89 |
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· 40th of 51
$36.31
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.