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 $7.08 Median $7.08 Typical High $7.76 | Facility | None | $7.08 | $7.08 | $7.76 |
Aetna Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $7.76 | Professional | None | $7.08 | $7.08 | $7.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.90 Median $7.24 Typical High $9.55 | Professional | None | $4.90 | $7.24 | $9.55 |
CareFirst Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $8.13 | Professional | None | $7.76 | $7.76 | $8.13 |
Cigna Setting Facility Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Facility | None | $7.59 | $7.59 | $7.59 |
Cigna Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $7.59 | Professional | None | $6.46 | $6.46 | $7.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $8.32 Median $11.75 Typical High $15.14 | Professional | None | $8.32 | $11.75 | $15.14 |
Medcost Setting Professional Modifier None Typical Low $7.41 Median $8.32 Typical High $11.48 | Professional | None | $7.41 | $8.32 | $11.48 |
Medcost Setting Facility Modifier None Typical Low $3.47 Median $6.31 Typical High $8.32 | Facility | None | $3.47 | $6.31 | $8.32 |
Medcost Setting Professional Modifier None Typical Low $6.31 Median $7.08 Typical High $7.59 | Professional | None | $6.31 | $7.08 | $7.59 |
Sentara Setting Facility Modifier None Typical Low $5.89 Median $8.71 Typical High $25.12 | Facility | None | $5.89 | $8.71 | $25.12 |
Sentara Setting Professional Modifier None Typical Low $7.59 Median $9.12 Typical High $17.78 | Professional | None | $7.59 | $9.12 | $17.78 |
United Setting Professional Modifier None Typical Low $4.90 Median $5.75 Typical High $8.71 | Professional | None | $4.90 | $5.75 | $8.71 |
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 $3.55 Median $3.55 Typical High $3.89 | Professional | 52 · Reduced service | $3.55 | $3.55 | $3.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.41 Median $1.41 Typical High $1.55 | Professional | 53 · Discontinued | $1.41 | $1.41 | $1.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.07 Median $1.07 Typical High $1.17 | Professional | 55 · Aftercare only | $1.07 | $1.07 | $1.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.71 Median $0.71 Typical High $0.78 | Professional | 56 · Pre-op care only | $0.71 | $0.71 | $0.78 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.58 Median $0.58 Typical High $0.81 | Professional | RR · Rental | $0.58 | $0.58 | $0.81 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.37 Median $4.37 Typical High $4.68 | Professional | UE · Used equipment | $4.37 | $4.37 | $4.68 |
Where Virginia sits
The same service costs 2.1 times more in Idaho 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· 27th of 51
$7.59
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.