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 $2.00 Median $2.00 Typical High $2.09 | Facility | None | $2.00 | $2.00 | $2.09 |
Aetna Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.09 | Professional | None | $2.00 | $2.00 | $2.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | None | $2.00 | $2.00 | $2.00 |
CareFirst Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $1.78 | Professional | None | $1.78 | $1.78 | $1.78 |
Cigna Setting Facility Modifier None Typical Low $2.88 Median $4.07 Typical High $5.13 | Facility | None | $2.88 | $4.07 | $5.13 |
Cigna Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | None | $2.00 | $2.00 | $2.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.70 Median $2.00 Typical High $2.51 | Professional | None | $1.70 | $2.00 | $2.51 |
Medcost Setting Professional Modifier None Typical Low $1.48 Median $1.48 Typical High $1.48 | Professional | None | $1.48 | $1.48 | $1.48 |
Medcost Setting Facility Modifier None Typical Low $1.70 Median $1.78 Typical High $1.78 | Facility | None | $1.70 | $1.78 | $1.78 |
Medcost Setting Professional Modifier None Typical Low $1.70 Median $2.40 Typical High $2.63 | Professional | None | $1.70 | $2.40 | $2.63 |
Sentara Setting Facility Modifier None Typical Low $1.91 Median $2.14 Typical High $2.63 | Facility | None | $1.91 | $2.14 | $2.63 |
Sentara Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.29 | Professional | None | $2.00 | $2.00 | $2.29 |
United Setting Professional Modifier None Typical Low $1.78 Median $1.86 Typical High $2.00 | Professional | None | $1.78 | $1.86 | $2.00 |
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 $1.00 Median $1.00 Typical High $1.05 | Professional | 52 · Reduced service | $1.00 | $1.00 | $1.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.40 Median $0.40 Typical High $0.42 | Professional | 53 · Discontinued | $0.40 | $0.40 | $0.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.30 Median $0.30 Typical High $0.31 | Professional | 55 · Aftercare only | $0.30 | $0.30 | $0.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.20 Median $0.20 Typical High $0.21 | Professional | 56 · Pre-op care only | $0.20 | $0.20 | $0.21 |
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· 37th of 51
$2.00
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.