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 $38.02 Median $39.81 Typical High $70.79 | Facility | None | $38.02 | $39.81 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $39.81 | Professional | None | $38.02 | $38.02 | $39.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $37.15 Median $75.86 Typical High $123.03 | Facility | None | $37.15 | $75.86 | $123.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
CareFirst Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $75.86 Typical High $97.72 | Facility | None | $54.95 | $75.86 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $32.36 Median $38.02 Typical High $43.65 | Professional | None | $32.36 | $38.02 | $43.65 |
Medcost Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $60.26 | Facility | None | $37.15 | $37.15 | $60.26 |
Medcost Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $43.65 | Professional | None | $28.18 | $28.18 | $43.65 |
Sentara Setting Facility Modifier None Typical Low $34.67 Median $38.90 Typical High $48.98 | Facility | None | $34.67 | $38.90 | $48.98 |
Sentara Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $41.69 | Professional | None | $38.02 | $38.02 | $41.69 |
United Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
United Setting Professional Modifier None Typical Low $37.15 Median $38.90 Typical High $41.69 | Professional | None | $37.15 | $38.90 | $41.69 |
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 $18.62 Median $18.62 Typical High $19.95 | Professional | 52 · Reduced service | $18.62 | $18.62 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.59 Typical High $7.94 | Professional | 53 · Discontinued | $7.59 | $7.59 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.62 Typical High $5.89 | Professional | 55 · Aftercare only | $5.62 | $5.62 | $5.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $3.98 | Professional | 56 · Pre-op care only | $3.80 | $3.80 | $3.98 |
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
$38.02
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.