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 $5.50 Median $5.50 Typical High $6.03 | Facility | None | $5.50 | $5.50 | $6.03 |
Aetna Setting Professional Modifier None Typical Low $4.68 Median $5.50 Typical High $6.03 | Professional | None | $4.68 | $5.50 | $6.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.95 Median $4.37 Typical High $6.03 | Professional | None | $2.95 | $4.37 | $6.03 |
CareFirst Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $6.31 | Professional | None | $5.13 | $5.13 | $6.31 |
Cigna Setting Facility Modifier None Typical Low $5.37 Median $5.37 Typical High $5.37 | Facility | None | $5.37 | $5.37 | $5.37 |
Cigna Setting Professional Modifier None Typical Low $4.57 Median $4.57 Typical High $5.37 | Professional | None | $4.57 | $4.57 | $5.37 |
Kaiser Permanente Setting Professional Modifier None Typical Low $6.46 Median $9.12 Typical High $12.02 | Professional | None | $6.46 | $9.12 | $12.02 |
Medcost Setting Professional Modifier None Typical Low $4.90 Median $5.50 Typical High $7.59 | Professional | None | $4.90 | $5.50 | $7.59 |
Medcost Setting Facility Modifier None Typical Low $2.69 Median $4.90 Typical High $6.46 | Facility | None | $2.69 | $4.90 | $6.46 |
Medcost Setting Professional Modifier None Typical Low $4.57 Median $4.90 Typical High $6.03 | Professional | None | $4.57 | $4.90 | $6.03 |
Sentara Setting Facility Modifier None Typical Low $4.57 Median $6.61 Typical High $19.50 | Facility | None | $4.57 | $6.61 | $19.50 |
Sentara Setting Professional Modifier None Typical Low $5.89 Median $7.08 Typical High $13.80 | Professional | None | $5.89 | $7.08 | $13.80 |
United Setting Professional Modifier None Typical Low $3.80 Median $4.47 Typical High $6.76 | Professional | None | $3.80 | $4.47 | $6.76 |
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 55 · Aftercare only Typical Low $0.83 Median $0.83 Typical High $0.91 | Professional | 55 · Aftercare only | $0.83 | $0.83 | $0.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.56 Median $0.56 Typical High $0.62 | Professional | 56 · Pre-op care only | $0.56 | $0.56 | $0.62 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.34 Median $0.34 Typical High $0.60 | Professional | RR · Rental | $0.34 | $0.34 | $0.60 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.57 Median $2.57 Typical High $2.82 | Professional | UE · Used equipment | $2.57 | $2.57 | $2.82 |
Where Virginia sits
The same service costs 4.2 times more in Hawaii than in Kentucky. 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· 27th of 51
$5.50
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.