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 $229.09 Median $229.09 Typical High $239.88 | Facility | None | $229.09 | $229.09 | $239.88 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $239.88 | Professional | None | $229.09 | $229.09 | $239.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $223.87 Median $457.09 Typical High $741.31 | Facility | None | $223.87 | $457.09 | $741.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
CareFirst Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $457.09 Typical High $588.84 | Facility | None | $331.13 | $457.09 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $190.55 Median $229.09 Typical High $269.15 | Professional | None | $190.55 | $229.09 | $269.15 |
Medcost Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $363.08 | Facility | None | $223.87 | $223.87 | $363.08 |
Medcost Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $263.03 | Professional | None | $165.96 | $165.96 | $263.03 |
Sentara Setting Facility Modifier None Typical Low $208.93 Median $234.42 Typical High $295.12 | Facility | None | $208.93 | $234.42 | $295.12 |
Sentara Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $245.47 | Professional | None | $229.09 | $229.09 | $245.47 |
United Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
United Setting Professional Modifier None Typical Low $223.87 Median $234.42 Typical High $245.47 | Professional | None | $223.87 | $234.42 | $245.47 |
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 $112.20 Median $112.20 Typical High $120.23 | Professional | 52 · Reduced service | $112.20 | $112.20 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $47.86 | Professional | 53 · Discontinued | $45.71 | $45.71 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $35.48 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $23.99 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $23.99 |
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· 51st of 51
$229
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.