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 $17.38 Median $18.20 Typical High $32.36 | Facility | None | $17.38 | $18.20 | $32.36 |
Aetna Setting Professional Modifier None Typical Low $17.38 Median $18.20 Typical High $19.05 | Professional | None | $17.38 | $18.20 | $19.05 |
Anthem BCBS Setting Facility Modifier None Typical Low $16.98 Median $34.67 Typical High $56.23 | Facility | None | $16.98 | $34.67 | $56.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
CareFirst Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | None | $16.98 | $16.98 | $16.98 |
Cigna Setting Facility Modifier None Typical Low $25.12 Median $34.67 Typical High $44.67 | Facility | None | $25.12 | $34.67 | $44.67 |
Cigna Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $14.45 Median $17.38 Typical High $19.50 | Professional | None | $14.45 | $17.38 | $19.50 |
Medcost Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $11.75 | Professional | None | $11.75 | $11.75 | $11.75 |
Medcost Setting Facility Modifier None Typical Low $16.98 Median $16.98 Typical High $21.88 | Facility | None | $16.98 | $16.98 | $21.88 |
Medcost Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $19.50 | Professional | None | $10.23 | $10.23 | $19.50 |
Sentara Setting Facility Modifier None Typical Low $15.85 Median $17.78 Typical High $22.39 | Facility | None | $15.85 | $17.78 | $22.39 |
Sentara Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $18.62 | Professional | None | $17.38 | $17.38 | $18.62 |
United Setting Facility Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Facility | None | $17.38 | $17.38 | $17.38 |
United Setting Professional Modifier None Typical Low $16.98 Median $18.20 Typical High $19.05 | Professional | None | $16.98 | $18.20 | $19.05 |
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 $8.51 Median $8.51 Typical High $9.12 | Professional | 52 · Reduced service | $8.51 | $8.51 | $9.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.47 Median $3.47 Typical High $3.63 | Professional | 53 · Discontinued | $3.47 | $3.47 | $3.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.57 Median $2.57 Typical High $2.69 | Professional | 55 · Aftercare only | $2.57 | $2.57 | $2.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.74 Median $1.74 Typical High $1.82 | Professional | 56 · Pre-op care only | $1.74 | $1.74 | $1.82 |
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· 32nd of 51
$17.38
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.