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 $3.24 Median $3.24 Typical High $3.55 | Facility | None | $3.24 | $3.24 | $3.55 |
Aetna Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.55 | Professional | None | $3.24 | $3.24 | $3.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.24 Median $3.31 Typical High $4.47 | Professional | None | $2.24 | $3.31 | $4.47 |
CareFirst Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.72 | Professional | None | $3.55 | $3.55 | $3.72 |
Cigna Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Facility | None | $3.55 | $3.55 | $3.55 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $3.55 | Professional | None | $2.95 | $2.95 | $3.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.72 Median $5.37 Typical High $6.92 | Professional | None | $3.72 | $5.37 | $6.92 |
Medcost Setting Professional Modifier None Typical Low $3.39 Median $3.80 Typical High $5.25 | Professional | None | $3.39 | $3.80 | $5.25 |
Medcost Setting Facility Modifier None Typical Low $1.58 Median $2.88 Typical High $3.80 | Facility | None | $1.58 | $2.88 | $3.80 |
Medcost Setting Professional Modifier None Typical Low $2.88 Median $3.02 Typical High $3.47 | Professional | None | $2.88 | $3.02 | $3.47 |
Sentara Setting Facility Modifier None Typical Low $2.69 Median $3.98 Typical High $11.48 | Facility | None | $2.69 | $3.98 | $11.48 |
Sentara Setting Professional Modifier None Typical Low $3.47 Median $4.17 Typical High $8.13 | Professional | None | $3.47 | $4.17 | $8.13 |
United Setting Professional Modifier None Typical Low $2.24 Median $2.63 Typical High $3.98 | Professional | None | $2.24 | $2.63 | $3.98 |
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 $1.62 Median $1.62 Typical High $1.78 | Professional | 52 · Reduced service | $1.62 | $1.62 | $1.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.65 Median $0.65 Typical High $0.71 | Professional | 53 · Discontinued | $0.65 | $0.65 | $0.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.49 Median $0.49 Typical High $0.52 | Professional | 55 · Aftercare only | $0.49 | $0.49 | $0.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.33 Median $0.33 Typical High $0.36 | Professional | 56 · Pre-op care only | $0.33 | $0.33 | $0.36 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.26 Median $0.26 Typical High $0.37 | Professional | RR · Rental | $0.26 | $0.26 | $0.37 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.95 Median $1.95 Typical High $2.14 | Professional | UE · Used equipment | $1.95 | $1.95 | $2.14 |
Where Virginia sits
The same service costs 2.6 times more in Kansas than in New Hampshire. 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· 30th of 51
$3.47
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.