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 $43.65 Median $45.71 Typical High $81.28 | Facility | None | $43.65 | $45.71 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $45.71 | Professional | None | $43.65 | $43.65 | $45.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $42.66 Median $89.13 Typical High $141.25 | Facility | None | $42.66 | $89.13 | $141.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
CareFirst Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $89.13 Typical High $112.20 | Facility | None | $63.10 | $89.13 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $37.15 Median $43.65 Typical High $50.12 | Professional | None | $37.15 | $43.65 | $50.12 |
Medcost Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
Medcost Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $56.23 | Facility | None | $42.66 | $42.66 | $56.23 |
Medcost Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $50.12 | Professional | None | $28.84 | $28.84 | $50.12 |
Sentara Setting Facility Modifier None Typical Low $39.81 Median $44.67 Typical High $57.54 | Facility | None | $39.81 | $44.67 | $57.54 |
Sentara Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $46.77 | Professional | None | $43.65 | $43.65 | $46.77 |
United Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
United Setting Professional Modifier None Typical Low $42.66 Median $44.67 Typical High $46.77 | Professional | None | $42.66 | $44.67 | $46.77 |
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 $21.88 Median $21.88 Typical High $22.91 | Professional | 52 · Reduced service | $21.88 | $21.88 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $9.12 | Professional | 53 · Discontinued | $8.71 | $8.71 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.61 Typical High $6.92 | Professional | 55 · Aftercare only | $6.61 | $6.61 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $4.57 | Professional | 56 · Pre-op care only | $4.37 | $4.37 | $4.57 |
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· 39th of 51
$43.65
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.