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 $31.62 Median $31.62 Typical High $31.62 | Facility | None | $31.62 | $31.62 | $31.62 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $32.36 Median $70.79 Typical High $109.65 | Facility | None | $32.36 | $70.79 | $109.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
CareFirst Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $63.10 Typical High $79.43 | Facility | None | $33.11 | $63.10 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Kaiser Permanente Setting Professional Modifier None Typical Low $12.88 Median $15.49 Typical High $20.89 | Professional | None | $12.88 | $15.49 | $20.89 |
Medcost Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $19.50 | Professional | None | $14.13 | $14.13 | $19.50 |
Medcost Setting Facility Modifier None Typical Low $28.84 Median $28.84 Typical High $61.66 | Facility | None | $28.84 | $28.84 | $61.66 |
Medcost Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $28.84 | Professional | None | $10.00 | $10.00 | $28.84 |
Sentara Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
United Setting Professional Modifier None Typical Low $30.90 Median $32.36 Typical High $34.67 | Professional | None | $30.90 | $32.36 | $34.67 |
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 $15.85 Median $15.85 Typical High $15.85 | Professional | 52 · Reduced service | $15.85 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | 53 · Discontinued | $6.31 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $4.68 Typical High $4.68 | Professional | 55 · Aftercare only | $4.68 | $4.68 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | 56 · Pre-op care only | $3.16 | $3.16 | $3.16 |
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· 30th of 51
$31.62
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.