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 $2.40 Median $2.40 Typical High $2.63 | Facility | None | $2.40 | $2.40 | $2.63 |
Aetna Setting Professional Modifier None Typical Low $2.40 Median $2.40 Typical High $2.63 | Professional | None | $2.40 | $2.40 | $2.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.75 | Professional | None | $2.00 | $2.00 | $2.75 |
CareFirst Setting Professional Modifier None Typical Low $2.63 Median $2.63 Typical High $2.75 | Professional | None | $2.63 | $2.63 | $2.75 |
Cigna Setting Facility Modifier None Typical Low $2.34 Median $2.34 Typical High $2.51 | Facility | None | $2.34 | $2.34 | $2.51 |
Cigna Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.34 | Professional | None | $2.00 | $2.00 | $2.34 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.82 Median $3.98 Typical High $5.13 | Professional | None | $2.82 | $3.98 | $5.13 |
Medcost Setting Professional Modifier None Typical Low $2.51 Median $2.75 Typical High $3.89 | Professional | None | $2.51 | $2.75 | $3.89 |
Medcost Setting Facility Modifier None Typical Low $1.17 Median $2.14 Typical High $2.82 | Facility | None | $1.17 | $2.14 | $2.82 |
Medcost Setting Professional Modifier None Typical Low $2.14 Median $2.40 Typical High $3.02 | Professional | None | $2.14 | $2.40 | $3.02 |
Sentara Setting Facility Modifier None Typical Low $2.00 Median $2.95 Typical High $8.51 | Facility | None | $2.00 | $2.95 | $8.51 |
Sentara Setting Professional Modifier None Typical Low $2.57 Median $3.09 Typical High $6.03 | Professional | None | $2.57 | $3.09 | $6.03 |
United Setting Professional Modifier None Typical Low $1.66 Median $1.95 Typical High $2.95 | Professional | None | $1.66 | $1.95 | $2.95 |
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 $1.20 Median $1.20 Typical High $1.32 | Professional | 52 · Reduced service | $1.20 | $1.20 | $1.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.48 Median $0.48 Typical High $0.52 | Professional | 53 · Discontinued | $0.48 | $0.48 | $0.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.36 Median $0.36 Typical High $0.39 | Professional | 55 · Aftercare only | $0.36 | $0.36 | $0.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.24 Median $0.24 Typical High $0.26 | Professional | 56 · Pre-op care only | $0.24 | $0.24 | $0.26 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.20 Median $0.20 Typical High $0.28 | Professional | RR · Rental | $0.20 | $0.20 | $0.28 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.45 Median $1.51 Typical High $1.58 | Professional | UE · Used equipment | $1.45 | $1.51 | $1.58 |
Where Virginia sits
The same service costs 2.2 times more in Kansas 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· 31st of 51
$2.40
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.