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 $1.62 Median $1.62 Typical High $1.74 | Facility | None | $1.62 | $1.62 | $1.74 |
Aetna Setting Professional Modifier None Typical Low $1.62 Median $1.62 Typical High $1.74 | Professional | None | $1.62 | $1.62 | $1.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.35 Median $1.35 Typical High $1.82 | Professional | None | $1.35 | $1.35 | $1.82 |
CareFirst Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $1.82 | Professional | None | $1.78 | $1.78 | $1.82 |
Cigna Setting Facility Modifier None Typical Low $1.55 Median $1.55 Typical High $1.66 | Facility | None | $1.55 | $1.55 | $1.66 |
Cigna Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.55 | Professional | None | $1.32 | $1.32 | $1.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.86 Median $2.63 Typical High $3.47 | Professional | None | $1.86 | $2.63 | $3.47 |
Medcost Setting Professional Modifier None Typical Low $1.66 Median $1.86 Typical High $2.57 | Professional | None | $1.66 | $1.86 | $2.57 |
Medcost Setting Facility Modifier None Typical Low $0.78 Median $1.45 Typical High $1.86 | Facility | None | $0.78 | $1.45 | $1.86 |
Medcost Setting Professional Modifier None Typical Low $1.45 Median $1.62 Typical High $2.00 | Professional | None | $1.45 | $1.62 | $2.00 |
Sentara Setting Facility Modifier None Typical Low $1.32 Median $1.95 Typical High $5.75 | Facility | None | $1.32 | $1.95 | $5.75 |
Sentara Setting Professional Modifier None Typical Low $1.70 Median $2.04 Typical High $4.07 | Professional | None | $1.70 | $2.04 | $4.07 |
United Setting Professional Modifier None Typical Low $1.10 Median $1.29 Typical High $1.95 | Professional | None | $1.10 | $1.29 | $1.95 |
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 $0.81 Median $0.81 Typical High $0.87 | Professional | 52 · Reduced service | $0.81 | $0.81 | $0.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.32 Median $0.32 Typical High $0.35 | Professional | 53 · Discontinued | $0.32 | $0.32 | $0.35 |
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 $0.18 | Professional | 56 · Pre-op care only | $0.16 | $0.16 | $0.18 |
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 $0.98 Median $1.00 Typical High $1.07 | Professional | UE · Used equipment | $0.98 | $1.00 | $1.07 |
Where Virginia sits
The same service costs 2.3 times more in Kansas than in New Jersey. 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· 29th of 51
$1.62
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.