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 $3.09 Median $3.09 Typical High $3.39 | Facility | None | $3.09 | $3.09 | $3.39 |
Aetna Setting Professional Modifier None Typical Low $2.88 Median $3.09 Typical High $3.39 | Professional | None | $2.88 | $3.09 | $3.39 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $3.55 | Professional | None | $2.69 | $2.69 | $3.55 |
CareFirst Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.47 | Professional | None | $3.39 | $3.39 | $3.47 |
Cigna Setting Facility Modifier None Typical Low $3.02 Median $3.02 Typical High $3.16 | Facility | None | $3.02 | $3.02 | $3.16 |
Cigna Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $3.02 | Professional | None | $2.57 | $2.57 | $3.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.55 Median $5.13 Typical High $6.61 | Professional | None | $3.55 | $5.13 | $6.61 |
Medcost Setting Professional Modifier None Typical Low $3.24 Median $3.55 Typical High $5.01 | Professional | None | $3.24 | $3.55 | $5.01 |
Medcost Setting Facility Modifier None Typical Low $1.51 Median $2.75 Typical High $3.55 | Facility | None | $1.51 | $2.75 | $3.55 |
Medcost Setting Professional Modifier None Typical Low $2.75 Median $3.02 Typical High $3.31 | Professional | None | $2.75 | $3.02 | $3.31 |
Sentara Setting Facility Modifier None Typical Low $2.51 Median $3.80 Typical High $10.96 | Facility | None | $2.51 | $3.80 | $10.96 |
Sentara Setting Professional Modifier None Typical Low $3.31 Median $3.98 Typical High $7.76 | Professional | None | $3.31 | $3.98 | $7.76 |
United Setting Professional Modifier None Typical Low $2.14 Median $2.51 Typical High $3.80 | Professional | None | $2.14 | $2.51 | $3.80 |
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 $1.55 Median $1.55 Typical High $1.70 | Professional | 52 · Reduced service | $1.55 | $1.55 | $1.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.62 Median $0.62 Typical High $0.68 | Professional | 53 · Discontinued | $0.62 | $0.62 | $0.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.46 Median $0.46 Typical High $0.51 | Professional | 55 · Aftercare only | $0.46 | $0.46 | $0.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.31 Median $0.31 Typical High $0.34 | Professional | 56 · Pre-op care only | $0.31 | $0.31 | $0.34 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.27 Median $0.27 Typical High $0.35 | Professional | RR · Rental | $0.27 | $0.27 | $0.35 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.86 Median $2.00 Typical High $2.04 | Professional | UE · Used equipment | $1.86 | $2.00 | $2.04 |
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· 31st of 51
$3.09
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.