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 $4.90 Median $4.90 Typical High $5.37 | Facility | None | $4.90 | $4.90 | $5.37 |
Aetna Setting Professional Modifier None Typical Low $4.17 Median $4.90 Typical High $5.37 | Professional | None | $4.17 | $4.90 | $5.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.17 Median $4.17 Typical High $5.75 | Professional | None | $4.17 | $4.17 | $5.75 |
CareFirst Setting Professional Modifier None Typical Low $5.37 Median $5.37 Typical High $5.62 | Professional | None | $5.37 | $5.37 | $5.62 |
Cigna Setting Facility Modifier None Typical Low $4.79 Median $4.79 Typical High $5.13 | Facility | None | $4.79 | $4.79 | $5.13 |
Cigna Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $4.79 | Professional | None | $4.07 | $4.07 | $4.79 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5.75 Median $8.13 Typical High $10.72 | Professional | None | $5.75 | $8.13 | $10.72 |
Medcost Setting Professional Modifier None Typical Low $5.13 Median $5.75 Typical High $7.94 | Professional | None | $5.13 | $5.75 | $7.94 |
Medcost Setting Facility Modifier None Typical Low $2.40 Median $4.37 Typical High $5.75 | Facility | None | $2.40 | $4.37 | $5.75 |
Medcost Setting Professional Modifier None Typical Low $4.37 Median $4.90 Typical High $5.37 | Professional | None | $4.37 | $4.90 | $5.37 |
Sentara Setting Facility Modifier None Typical Low $4.07 Median $6.17 Typical High $23.44 | Facility | None | $4.07 | $6.17 | $23.44 |
Sentara Setting Professional Modifier None Typical Low $5.25 Median $6.46 Typical High $13.18 | Professional | None | $5.25 | $6.46 | $13.18 |
United Setting Professional Modifier None Typical Low $3.39 Median $3.98 Typical High $6.03 | Professional | None | $3.39 | $3.98 | $6.03 |
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 $0.74 Median $0.74 Typical High $0.81 | Professional | 55 · Aftercare only | $0.74 | $0.74 | $0.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.49 Median $0.49 Typical High $0.54 | Professional | 56 · Pre-op care only | $0.49 | $0.49 | $0.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.41 Median $0.41 Typical High $0.56 | Professional | RR · Rental | $0.41 | $0.41 | $0.56 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.02 Median $3.09 Typical High $3.24 | Professional | UE · Used equipment | $3.02 | $3.09 | $3.24 |
Where Virginia sits
The same service costs 2.3 times more in Kansas than in Utah. 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· 30th of 51
$4.90
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.