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 $25.70 Median $33.88 Typical High $43.65 | Facility | None | $25.70 | $33.88 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $26.30 Typical High $26.92 | Professional | None | $25.70 | $26.30 | $26.92 |
Anthem BCBS Setting Facility Modifier None Typical Low $25.70 Median $52.48 Typical High $85.11 | Facility | None | $25.70 | $52.48 | $85.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
CareFirst Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Cigna Setting Facility Modifier None Typical Low $31.62 Median $48.98 Typical High $64.57 | Facility | None | $31.62 | $48.98 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $21.88 Median $25.70 Typical High $66.07 | Professional | None | $21.88 | $25.70 | $66.07 |
Medcost Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $41.69 | Facility | None | $25.70 | $25.70 | $41.69 |
Medcost Setting Professional Modifier None Typical Low $25.70 Median $33.88 Typical High $74.13 | Professional | None | $25.70 | $33.88 | $74.13 |
Sentara Setting Facility Modifier None Typical Low $26.30 Median $66.07 Typical High $69.18 | Facility | None | $26.30 | $66.07 | $69.18 |
Sentara Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $69.18 | Professional | None | $25.70 | $25.70 | $69.18 |
United Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Facility | None | $25.70 | $25.70 | $25.70 |
United Setting Professional Modifier None Typical Low $25.70 Median $27.54 Typical High $28.84 | Professional | None | $25.70 | $27.54 | $28.84 |
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 $12.88 Median $12.88 Typical High $13.49 | Professional | 52 · Reduced service | $12.88 | $12.88 | $13.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $5.13 Typical High $5.50 | Professional | 53 · Discontinued | $5.13 | $5.13 | $5.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $3.89 Typical High $4.07 | Professional | 55 · Aftercare only | $3.89 | $3.89 | $4.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $2.57 Typical High $2.69 | Professional | 56 · Pre-op care only | $2.57 | $2.57 | $2.69 |
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· 23rd of 51
$25.70
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.