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 $15.14 Median $19.05 Typical High $54.95 | Facility | None | $15.14 | $19.05 | $54.95 |
Aetna Setting Professional Modifier None Typical Low $15.14 Median $18.20 Typical High $50.12 | Professional | None | $15.14 | $18.20 | $50.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $20.42 Median $20.42 Typical High $100.00 | Facility | None | $20.42 | $20.42 | $100.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $19.05 | Professional | None | $11.48 | $11.48 | $19.05 |
CareFirst Setting Professional Modifier None Typical Low $14.45 Median $16.22 Typical High $19.05 | Professional | None | $14.45 | $16.22 | $19.05 |
Cigna Setting Facility Modifier None Typical Low $20.42 Median $48.98 Typical High $79.43 | Facility | None | $20.42 | $48.98 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $16.60 Typical High $45.71 | Professional | None | $12.02 | $16.60 | $45.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $19.05 Median $22.39 Typical High $28.18 | Professional | None | $19.05 | $22.39 | $28.18 |
Medcost Setting Facility Modifier None Typical Low $40.74 Median $41.69 Typical High $41.69 | Facility | None | $40.74 | $41.69 | $41.69 |
Medcost Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $37.15 | Professional | None | $16.22 | $16.22 | $37.15 |
Sentara Setting Facility Modifier None Typical Low $19.95 Median $34.67 Typical High $10,232.93 | Facility | None | $19.95 | $34.67 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $20.42 Median $29.51 Typical High $41.69 | Professional | None | $20.42 | $29.51 | $41.69 |
United Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
United Setting Professional Modifier None Typical Low $12.02 Median $20.42 Typical High $45.71 | Professional | None | $12.02 | $20.42 | $45.71 |
2 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 $7.59 Median $7.59 Typical High $9.55 | Professional | 52 · Reduced service | $7.59 | $7.59 | $9.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $3.02 Typical High $3.80 | Professional | 53 · Discontinued | $3.02 | $3.02 | $3.80 |
Where Virginia sits
The same service costs 4.6 times more in Vermont than in Illinois. 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· 38th of 51
$20.42
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.