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 $1.32 Median $1.38 Typical High $1.38 | Facility | None | $1.32 | $1.38 | $1.38 |
Aetna Setting Professional Modifier None Typical Low $1.17 Median $1.38 Typical High $1.38 | Professional | None | $1.17 | $1.38 | $1.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.26 | Professional | None | $1.12 | $1.12 | $1.26 |
CareFirst Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.38 | Professional | None | $1.32 | $1.32 | $1.38 |
Cigna Setting Facility Modifier None Typical Low $0.72 Median $1.35 Typical High $1.35 | Facility | None | $0.72 | $1.35 | $1.35 |
Cigna Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.35 | Professional | None | $1.12 | $1.12 | $1.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.38 Median $2.00 Typical High $2.88 | Professional | None | $1.38 | $2.00 | $2.88 |
Medcost Setting Professional Modifier None Typical Low $1.45 Median $1.58 Typical High $2.24 | Professional | None | $1.45 | $1.58 | $2.24 |
Medcost Setting Facility Modifier None Typical Low $0.68 Median $1.23 Typical High $1.48 | Facility | None | $0.68 | $1.23 | $1.48 |
Medcost Setting Professional Modifier None Typical Low $1.00 Median $1.15 Typical High $1.48 | Professional | None | $1.00 | $1.15 | $1.48 |
Sentara Setting Facility Modifier None Typical Low $1.12 Median $1.66 Typical High $6.61 | Facility | None | $1.12 | $1.66 | $6.61 |
Sentara Setting Professional Modifier None Typical Low $1.48 Median $1.82 Typical High $3.72 | Professional | None | $1.48 | $1.82 | $3.72 |
United Setting Professional Modifier None Typical Low $0.93 Median $1.10 Typical High $1.45 | Professional | None | $0.93 | $1.10 | $1.45 |
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 $0.20 Median $0.21 Typical High $0.21 | Professional | 55 · Aftercare only | $0.20 | $0.21 | $0.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.14 Typical High $0.14 | Professional | 56 · Pre-op care only | $0.13 | $0.14 | $0.14 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.11 Median $0.11 Typical High $0.14 | Professional | RR · Rental | $0.11 | $0.11 | $0.14 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.83 Median $0.85 Typical High $0.89 | Professional | UE · Used equipment | $0.83 | $0.85 | $0.89 |
Where Virginia sits
The same service costs 5.8 times more in Hawaii than in Rhode Island. 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· 41st of 51
$1.12
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.