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 $5.13 Median $5.13 Typical High $5.62 | Facility | None | $5.13 | $5.13 | $5.62 |
Aetna Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $5.62 | Professional | None | $5.13 | $5.13 | $5.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $6.03 | Professional | None | $4.37 | $4.37 | $6.03 |
CareFirst Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $5.89 | Professional | None | $5.62 | $5.62 | $5.89 |
Cigna Setting Facility Modifier None Typical Low $5.01 Median $5.01 Typical High $5.37 | Facility | None | $5.01 | $5.01 | $5.37 |
Cigna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $5.01 | Professional | None | $4.27 | $4.27 | $5.01 |
Kaiser Permanente Setting Professional Modifier None Typical Low $6.03 Median $8.51 Typical High $11.22 | Professional | None | $6.03 | $8.51 | $11.22 |
Medcost Setting Professional Modifier None Typical Low $5.37 Median $6.03 Typical High $8.32 | Professional | None | $5.37 | $6.03 | $8.32 |
Medcost Setting Facility Modifier None Typical Low $2.51 Median $4.57 Typical High $6.03 | Facility | None | $2.51 | $4.57 | $6.03 |
Medcost Setting Professional Modifier None Typical Low $4.57 Median $5.01 Typical High $5.62 | Professional | None | $4.57 | $5.01 | $5.62 |
Sentara Setting Facility Modifier None Typical Low $4.27 Median $6.46 Typical High $24.55 | Facility | None | $4.27 | $6.46 | $24.55 |
Sentara Setting Professional Modifier None Typical Low $5.50 Median $6.61 Typical High $12.88 | Professional | None | $5.50 | $6.61 | $12.88 |
United Setting Professional Modifier None Typical Low $3.55 Median $4.17 Typical High $6.31 | Professional | None | $3.55 | $4.17 | $6.31 |
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 $0.78 Median $0.78 Typical High $0.85 | Professional | 55 · Aftercare only | $0.78 | $0.78 | $0.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.52 Typical High $0.56 | Professional | 56 · Pre-op care only | $0.52 | $0.52 | $0.56 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.43 Median $0.43 Typical High $0.60 | Professional | RR · Rental | $0.43 | $0.43 | $0.60 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.16 Median $3.24 Typical High $3.39 | Professional | UE · Used equipment | $3.16 | $3.24 | $3.39 |
Where Virginia sits
The same service costs 2.1 times more in Hawaii than in Delaware. 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· 28th of 51
$5.13
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.