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 $1.00 Median $1.00 Typical High $1.07 | Facility | None | $1.00 | $1.00 | $1.07 |
Aetna Setting Professional Modifier None Typical Low $1.00 Median $1.07 Typical High $1.07 | Professional | None | $1.00 | $1.07 | $1.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.15 Median $0.16 Typical High $0.16 | Professional | 55 · Aftercare only | $0.15 | $0.16 | $0.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.11 Typical High $0.11 | Professional | 56 · Pre-op care only | $0.10 | $0.11 | $0.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.41 Median $1.41 Typical High $1.41 | Professional | None | $1.41 | $1.41 | $1.41 |
CareFirst Setting Professional Modifier None Typical Low $1.48 Median $1.48 Typical High $1.48 | Professional | None | $1.48 | $1.48 | $1.48 |
Cigna Setting Facility Modifier None Typical Low $1.20 Median $1.20 Typical High $1.20 | Facility | None | $1.20 | $1.20 | $1.20 |
Cigna Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $1.02 | Professional | None | $1.02 | $1.02 | $1.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.20 Median $1.55 Typical High $2.29 | Professional | None | $1.20 | $1.55 | $2.29 |
Medcost Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $16.22 | Professional | None | $11.48 | $11.48 | $16.22 |
Medcost Setting Facility Modifier None Typical Low $1.07 Median $2.57 Typical High $18.62 | Facility | None | $1.07 | $2.57 | $18.62 |
Medcost Setting Professional Modifier None Typical Low $7.94 Median $7.94 Typical High $12.59 | Professional | None | $7.94 | $7.94 | $12.59 |
Sentara Setting Facility Modifier None Typical Low $1.45 Median $7.41 Typical High $7,413.10 | Facility | None | $1.45 | $7.41 | $7,413.10 |
Sentara Setting Professional Modifier None Typical Low $1.29 Median $2.63 Typical High $14.79 | Professional | None | $1.29 | $2.63 | $14.79 |
United Setting Professional Modifier None Typical Low $0.85 Median $0.85 Typical High $10.72 | Professional | None | $0.85 | $0.85 | $10.72 |
1 more rate 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 |
|---|---|---|---|---|---|
Sentara Setting Professional Modifier KL · Delivered by mail Typical Low $10.23 Median $11.48 Typical High $13.49 | Professional | KL · Delivered by mail | $10.23 | $11.48 | $13.49 |
Where Virginia sits
The same service costs 7.4 times more in Kentucky than in Delaware. 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· 17th of 51
$1.41
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.