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 $331.13 Median $331.13 Typical High $346.74 | Facility | None | $331.13 | $331.13 | $346.74 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $346.74 | Professional | None | $331.13 | $331.13 | $346.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $323.59 Median $676.08 Typical High $1,071.52 | Facility | None | $323.59 | $676.08 | $1,071.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
CareFirst Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $676.08 Typical High $851.14 | Facility | None | $478.63 | $676.08 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $281.84 Median $331.13 Typical High $389.05 | Professional | None | $281.84 | $331.13 | $389.05 |
Medcost Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $524.81 | Facility | None | $323.59 | $323.59 | $524.81 |
Medcost Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $389.05 | Professional | None | $251.19 | $251.19 | $389.05 |
Sentara Setting Facility Modifier None Typical Low $309.03 Median $346.74 Typical High $436.52 | Facility | None | $309.03 | $346.74 | $436.52 |
Sentara Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $371.54 | Professional | None | $331.13 | $331.13 | $371.54 |
United Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
United Setting Professional Modifier None Typical Low $323.59 Median $338.84 Typical High $363.08 | Professional | None | $323.59 | $338.84 | $363.08 |
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 $165.96 Median $165.96 Typical High $173.78 | Professional | 52 · Reduced service | $165.96 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $69.18 | Professional | 53 · Discontinued | $66.07 | $66.07 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $52.48 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $34.67 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $34.67 |
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· 28th of 51
$331
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.