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 $0.79 Median $0.83 Typical High $1.05 | Facility | None | $0.79 | $0.83 | $1.05 |
Aetna Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $0.83 | Professional | None | $0.79 | $0.79 | $0.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.79 Median $1.74 Typical High $2.69 | Facility | None | $0.79 | $1.74 | $2.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | None | $0.79 | $0.79 | $0.79 |
CareFirst Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | None | $0.79 | $0.79 | $0.79 |
Cigna Setting Facility Modifier None Typical Low $1.17 Median $1.51 Typical High $2.04 | Facility | None | $1.17 | $1.51 | $2.04 |
Cigna Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | None | $0.79 | $0.79 | $0.79 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.68 Median $0.79 Typical High $1.29 | Professional | None | $0.68 | $0.79 | $1.29 |
Medcost Setting Facility Modifier None Typical Low $0.79 Median $0.79 Typical High $1.74 | Facility | None | $0.79 | $0.79 | $1.74 |
Medcost Setting Professional Modifier None Typical Low $0.79 Median $1.15 Typical High $1.32 | Professional | None | $0.79 | $1.15 | $1.32 |
Sentara Setting Facility Modifier None Typical Low $0.79 Median $1.17 Typical High $1.26 | Facility | None | $0.79 | $1.17 | $1.26 |
Sentara Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $1.26 | Professional | None | $0.79 | $0.79 | $1.26 |
United Setting Professional Modifier None Typical Low $0.79 Median $0.83 Typical High $0.87 | Professional | None | $0.79 | $0.83 | $0.87 |
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 $0.40 Median $0.40 Typical High $0.42 | Professional | 52 · Reduced service | $0.40 | $0.40 | $0.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.16 Median $0.16 Typical High $0.17 | Professional | 53 · Discontinued | $0.16 | $0.16 | $0.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.12 Median $0.12 Typical High $0.13 | Professional | 55 · Aftercare only | $0.12 | $0.12 | $0.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.08 Typical High $0.08 | Professional | 56 · Pre-op care only | $0.08 | $0.08 | $0.08 |
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· 19th of 51
$0.79
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.