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 $4.27 Median $4.27 Typical High $4.68 | Facility | None | $4.27 | $4.27 | $4.68 |
Aetna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.68 | Professional | None | $4.27 | $4.27 | $4.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $4.90 | Professional | None | $3.55 | $3.55 | $4.90 |
CareFirst Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $4.79 | Professional | None | $4.68 | $4.68 | $4.79 |
Cigna Setting Facility Modifier None Typical Low $4.17 Median $4.17 Typical High $4.47 | Facility | None | $4.17 | $4.17 | $4.47 |
Cigna Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $4.17 | Professional | None | $3.55 | $3.55 | $4.17 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.90 Median $7.08 Typical High $9.12 | Professional | None | $4.90 | $7.08 | $9.12 |
Medcost Setting Professional Modifier None Typical Low $4.47 Median $4.90 Typical High $6.92 | Professional | None | $4.47 | $4.90 | $6.92 |
Medcost Setting Facility Modifier None Typical Low $2.09 Median $3.80 Typical High $4.90 | Facility | None | $2.09 | $3.80 | $4.90 |
Medcost Setting Professional Modifier None Typical Low $3.80 Median $3.98 Typical High $4.57 | Professional | None | $3.80 | $3.98 | $4.57 |
Sentara Setting Facility Modifier None Typical Low $3.47 Median $5.25 Typical High $20.42 | Facility | None | $3.47 | $5.25 | $20.42 |
Sentara Setting Professional Modifier None Typical Low $4.57 Median $5.37 Typical High $10.72 | Professional | None | $4.57 | $5.37 | $10.72 |
United Setting Professional Modifier None Typical Low $2.95 Median $3.47 Typical High $5.13 | Professional | None | $2.95 | $3.47 | $5.13 |
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 $0.65 Median $0.65 Typical High $0.71 | Professional | 55 · Aftercare only | $0.65 | $0.65 | $0.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.43 Median $0.43 Typical High $0.46 | Professional | 56 · Pre-op care only | $0.43 | $0.43 | $0.46 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.36 Median $0.36 Typical High $0.49 | Professional | RR · Rental | $0.36 | $0.36 | $0.49 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.57 Median $2.69 Typical High $2.82 | Professional | UE · Used equipment | $2.57 | $2.69 | $2.82 |
Where Virginia sits
The same service costs 2.1 times more in Hawaii than in Alabama. 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
$4.27
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.