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 $3.63 Median $3.63 Typical High $3.98 | Facility | None | $3.63 | $3.63 | $3.98 |
Aetna Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $3.98 | Professional | None | $3.63 | $3.63 | $3.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $4.17 | Professional | None | $3.02 | $3.02 | $4.17 |
CareFirst Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $4.07 | Professional | None | $3.98 | $3.98 | $4.07 |
Cigna Setting Facility Modifier None Typical Low $3.80 Median $3.80 Typical High $3.80 | Facility | None | $3.80 | $3.80 | $3.80 |
Cigna Setting Professional Modifier None Typical Low $2.45 Median $3.24 Typical High $3.24 | Professional | None | $2.45 | $3.24 | $3.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.17 Median $6.03 Typical High $7.76 | Professional | None | $4.17 | $6.03 | $7.76 |
Medcost Setting Professional Modifier None Typical Low $3.80 Median $4.17 Typical High $5.89 | Professional | None | $3.80 | $4.17 | $5.89 |
Medcost Setting Facility Modifier None Typical Low $1.78 Median $3.24 Typical High $4.17 | Facility | None | $1.78 | $3.24 | $4.17 |
Medcost Setting Professional Modifier None Typical Low $3.24 Median $3.63 Typical High $3.98 | Professional | None | $3.24 | $3.63 | $3.98 |
Sentara Setting Facility Modifier None Typical Low $2.95 Median $4.37 Typical High $12.88 | Facility | None | $2.95 | $4.37 | $12.88 |
Sentara Setting Professional Modifier None Typical Low $3.89 Median $4.68 Typical High $9.12 | Professional | None | $3.89 | $4.68 | $9.12 |
United Setting Professional Modifier None Typical Low $2.45 Median $2.95 Typical High $4.37 | Professional | None | $2.45 | $2.95 | $4.37 |
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 $0.54 Median $0.54 Typical High $0.59 | Professional | 55 · Aftercare only | $0.54 | $0.54 | $0.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.36 Median $0.36 Typical High $0.40 | Professional | 56 · Pre-op care only | $0.36 | $0.36 | $0.40 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.30 Median $0.30 Typical High $0.42 | Professional | RR · Rental | $0.30 | $0.30 | $0.42 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.19 Median $2.24 Typical High $2.40 | Professional | UE · Used equipment | $2.19 | $2.24 | $2.40 |
Where Virginia sits
The same service costs 3.2 times more in Kansas than in New Hampshire. 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· 24th of 51
$3.55
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.