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 $5.62 Median $5.62 Typical High $6.17 | Facility | None | $5.62 | $5.62 | $6.17 |
Aetna Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $6.17 | Professional | None | $5.62 | $5.62 | $6.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $6.46 | Professional | None | $4.68 | $4.68 | $6.46 |
CareFirst Setting Professional Modifier None Typical Low $6.17 Median $6.17 Typical High $6.31 | Professional | None | $6.17 | $6.17 | $6.31 |
Cigna Setting Facility Modifier None Typical Low $5.50 Median $5.50 Typical High $5.75 | Facility | None | $5.50 | $5.50 | $5.75 |
Cigna Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $5.50 | Professional | None | $4.68 | $4.68 | $5.50 |
Kaiser Permanente Setting Professional Modifier None Typical Low $6.46 Median $9.33 Typical High $12.02 | Professional | None | $6.46 | $9.33 | $12.02 |
Medcost Setting Professional Modifier None Typical Low $5.89 Median $6.46 Typical High $9.12 | Professional | None | $5.89 | $6.46 | $9.12 |
Medcost Setting Facility Modifier None Typical Low $2.75 Median $5.01 Typical High $6.46 | Facility | None | $2.75 | $5.01 | $6.46 |
Medcost Setting Professional Modifier None Typical Low $5.01 Median $5.62 Typical High $6.03 | Professional | None | $5.01 | $5.62 | $6.03 |
Sentara Setting Facility Modifier None Typical Low $4.90 Median $7.08 Typical High $19.05 | Facility | None | $4.90 | $7.08 | $19.05 |
Sentara Setting Professional Modifier None Typical Low $6.03 Median $7.41 Typical High $14.13 | Professional | None | $6.03 | $7.41 | $14.13 |
United Setting Professional Modifier None Typical Low $3.89 Median $4.57 Typical High $6.92 | Professional | None | $3.89 | $4.57 | $6.92 |
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 $2.82 Median $2.82 Typical High $3.09 | Professional | 52 · Reduced service | $2.82 | $2.82 | $3.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.12 Median $1.12 Typical High $1.23 | Professional | 53 · Discontinued | $1.12 | $1.12 | $1.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.83 Median $0.83 Typical High $0.91 | Professional | 55 · Aftercare only | $0.83 | $0.83 | $0.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.56 Median $0.56 Typical High $0.62 | Professional | 56 · Pre-op care only | $0.56 | $0.56 | $0.62 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.47 Median $0.47 Typical High $0.65 | Professional | RR · Rental | $0.47 | $0.47 | $0.65 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.39 Median $3.55 Typical High $3.72 | Professional | UE · Used equipment | $3.39 | $3.55 | $3.72 |
Where Virginia sits
The same service costs 2.3 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
$5.62
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.