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 $7.41 Median $7.41 Typical High $7.94 | Facility | None | $7.41 | $7.41 | $7.94 |
Aetna Setting Professional Modifier None Typical Low $7.41 Median $7.41 Typical High $7.94 | Professional | None | $7.41 | $7.41 | $7.94 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.17 Median $6.17 Typical High $8.51 | Professional | None | $6.17 | $6.17 | $8.51 |
CareFirst Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | None | $8.51 | $8.51 | $8.51 |
Cigna Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $7.59 | Facility | None | $7.08 | $7.08 | $7.59 |
Cigna Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $7.08 | Professional | None | $6.03 | $6.03 | $7.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $8.51 Median $12.02 Typical High $15.85 | Professional | None | $8.51 | $12.02 | $15.85 |
Medcost Setting Professional Modifier None Typical Low $7.59 Median $8.51 Typical High $12.02 | Professional | None | $7.59 | $8.51 | $12.02 |
Medcost Setting Facility Modifier None Typical Low $3.63 Median $6.46 Typical High $8.51 | Facility | None | $3.63 | $6.46 | $8.51 |
Medcost Setting Professional Modifier None Typical Low $6.46 Median $7.41 Typical High $7.94 | Professional | None | $6.46 | $7.41 | $7.94 |
Sentara Setting Facility Modifier None Typical Low $6.03 Median $8.91 Typical High $26.30 | Facility | None | $6.03 | $8.91 | $26.30 |
Sentara Setting Professional Modifier None Typical Low $7.76 Median $9.33 Typical High $18.62 | Professional | None | $7.76 | $9.33 | $18.62 |
United Setting Professional Modifier None Typical Low $5.01 Median $5.89 Typical High $8.91 | Professional | None | $5.01 | $5.89 | $8.91 |
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 $3.72 Median $3.72 Typical High $3.98 | Professional | 52 · Reduced service | $3.72 | $3.72 | $3.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.48 Median $1.48 Typical High $1.62 | Professional | 53 · Discontinued | $1.48 | $1.48 | $1.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.10 Median $1.10 Typical High $1.20 | Professional | 55 · Aftercare only | $1.10 | $1.10 | $1.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.74 Median $0.74 Typical High $0.79 | Professional | 56 · Pre-op care only | $0.74 | $0.74 | $0.79 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.62 Median $0.62 Typical High $0.83 | Professional | RR · Rental | $0.62 | $0.62 | $0.83 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.47 Median $4.57 Typical High $4.79 | Professional | UE · Used equipment | $4.47 | $4.57 | $4.79 |
Where Virginia sits
The same service costs 2.1 times more in Hawaii 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· 29th of 51
$7.41
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.