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 $4.07 Median $4.07 Typical High $4.47 | Facility | None | $4.07 | $4.07 | $4.47 |
Aetna Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $4.47 | Professional | None | $4.07 | $4.07 | $4.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $4.79 | Professional | None | $3.47 | $3.47 | $4.79 |
CareFirst Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $4.68 | Professional | None | $4.47 | $4.47 | $4.68 |
Cigna Setting Facility Modifier None Typical Low $3.98 Median $3.98 Typical High $4.27 | Facility | None | $3.98 | $3.98 | $4.27 |
Cigna Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.98 | Professional | None | $3.39 | $3.39 | $3.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.79 Median $6.76 Typical High $8.71 | Professional | None | $4.79 | $6.76 | $8.71 |
Medcost Setting Professional Modifier None Typical Low $4.27 Median $4.79 Typical High $6.61 | Professional | None | $4.27 | $4.79 | $6.61 |
Medcost Setting Facility Modifier None Typical Low $2.00 Median $3.63 Typical High $4.79 | Facility | None | $2.00 | $3.63 | $4.79 |
Medcost Setting Professional Modifier None Typical Low $3.63 Median $3.98 Typical High $4.47 | Professional | None | $3.63 | $3.98 | $4.47 |
Sentara Setting Facility Modifier None Typical Low $3.39 Median $5.01 Typical High $14.45 | Facility | None | $3.39 | $5.01 | $14.45 |
Sentara Setting Professional Modifier None Typical Low $4.37 Median $5.25 Typical High $10.23 | Professional | None | $4.37 | $5.25 | $10.23 |
United Setting Professional Modifier None Typical Low $2.82 Median $3.31 Typical High $5.01 | Professional | None | $2.82 | $3.31 | $5.01 |
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 $2.04 Median $2.04 Typical High $2.24 | Professional | 52 · Reduced service | $2.04 | $2.04 | $2.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.81 Median $0.81 Typical High $0.89 | Professional | 53 · Discontinued | $0.81 | $0.81 | $0.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.62 Median $0.62 Typical High $0.68 | Professional | 55 · Aftercare only | $0.62 | $0.62 | $0.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.41 Median $0.41 Typical High $0.45 | Professional | 56 · Pre-op care only | $0.41 | $0.41 | $0.45 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.34 Median $0.34 Typical High $0.47 | Professional | RR · Rental | $0.34 | $0.34 | $0.47 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.51 Median $2.57 Typical High $2.69 | Professional | UE · Used equipment | $2.51 | $2.57 | $2.69 |
Where Virginia sits
The same service costs 2.1 times more in Kansas 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· 28th of 51
$4.07
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.