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 $1.58 Median $1.58 Typical High $1.70 | Facility | None | $1.58 | $1.58 | $1.70 |
Aetna Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $1.70 | Professional | None | $1.58 | $1.58 | $1.70 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.07 Median $1.62 Typical High $2.14 | Professional | None | $1.07 | $1.62 | $2.14 |
CareFirst Setting Professional Modifier None Typical Low $1.70 Median $1.70 Typical High $1.78 | Professional | None | $1.70 | $1.70 | $1.78 |
Cigna Setting Facility Modifier None Typical Low $1.70 Median $1.70 Typical High $1.70 | Facility | None | $1.70 | $1.70 | $1.70 |
Cigna Setting Professional Modifier None Typical Low $1.45 Median $1.45 Typical High $1.70 | Professional | None | $1.45 | $1.45 | $1.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.82 Median $2.57 Typical High $3.39 | Professional | None | $1.82 | $2.57 | $3.39 |
Medcost Setting Professional Modifier None Typical Low $1.62 Median $1.82 Typical High $2.51 | Professional | None | $1.62 | $1.82 | $2.51 |
Medcost Setting Facility Modifier None Typical Low $0.76 Median $1.38 Typical High $1.82 | Facility | None | $0.76 | $1.38 | $1.82 |
Medcost Setting Professional Modifier None Typical Low $1.38 Median $1.58 Typical High $2.00 | Professional | None | $1.38 | $1.58 | $2.00 |
Sentara Setting Facility Modifier None Typical Low $1.29 Median $1.91 Typical High $5.62 | Facility | None | $1.29 | $1.91 | $5.62 |
Sentara Setting Professional Modifier None Typical Low $1.66 Median $2.00 Typical High $3.98 | Professional | None | $1.66 | $2.00 | $3.98 |
United Setting Professional Modifier None Typical Low $1.07 Median $1.26 Typical High $1.91 | Professional | None | $1.07 | $1.26 | $1.91 |
6 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 52 · Reduced service Typical Low $0.79 Median $0.79 Typical High $0.85 | Professional | 52 · Reduced service | $0.79 | $0.79 | $0.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.31 Median $0.31 Typical High $0.34 | Professional | 53 · Discontinued | $0.31 | $0.31 | $0.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.24 Median $0.24 Typical High $0.26 | Professional | 55 · Aftercare only | $0.24 | $0.24 | $0.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.16 Median $0.16 Typical High $0.17 | Professional | 56 · Pre-op care only | $0.16 | $0.16 | $0.17 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.13 Median $0.13 Typical High $0.18 | Professional | RR · Rental | $0.13 | $0.13 | $0.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.95 Median $0.95 Typical High $1.02 | Professional | UE · Used equipment | $0.95 | $0.95 | $1.02 |
Where Virginia sits
The same service costs 2.3 times more in Kansas than in Connecticut. 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
$1.66
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.