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 $2.75 Median $2.75 Typical High $3.02 | Facility | None | $2.75 | $2.75 | $3.02 |
Aetna Setting Professional Modifier None Typical Low $2.51 Median $2.75 Typical High $3.02 | Professional | None | $2.51 | $2.75 | $3.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.91 Median $2.88 Typical High $3.80 | Professional | None | $1.91 | $2.88 | $3.80 |
CareFirst Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.09 | Professional | None | $3.02 | $3.02 | $3.09 |
Cigna Setting Facility Modifier None Typical Low $2.69 Median $2.69 Typical High $3.31 | Facility | None | $2.69 | $2.69 | $3.31 |
Cigna Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $2.69 | Professional | None | $2.29 | $2.29 | $2.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.16 Median $4.57 Typical High $5.89 | Professional | None | $3.16 | $4.57 | $5.89 |
Medcost Setting Professional Modifier None Typical Low $2.88 Median $3.16 Typical High $4.47 | Professional | None | $2.88 | $3.16 | $4.47 |
Medcost Setting Facility Modifier None Typical Low $1.35 Median $2.45 Typical High $3.16 | Facility | None | $1.35 | $2.45 | $3.16 |
Medcost Setting Professional Modifier None Typical Low $2.00 Median $2.45 Typical High $2.95 | Professional | None | $2.00 | $2.45 | $2.95 |
Sentara Setting Facility Modifier None Typical Low $2.29 Median $3.31 Typical High $9.77 | Facility | None | $2.29 | $3.31 | $9.77 |
Sentara Setting Professional Modifier None Typical Low $2.95 Median $3.55 Typical High $6.92 | Professional | None | $2.95 | $3.55 | $6.92 |
United Setting Professional Modifier None Typical Low $1.91 Median $2.24 Typical High $3.39 | Professional | None | $1.91 | $2.24 | $3.39 |
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 $1.38 Median $1.38 Typical High $1.51 | Professional | 52 · Reduced service | $1.38 | $1.38 | $1.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.55 Median $0.55 Typical High $0.60 | Professional | 53 · Discontinued | $0.55 | $0.55 | $0.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.41 Median $0.41 Typical High $0.45 | Professional | 55 · Aftercare only | $0.41 | $0.41 | $0.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $0.30 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $0.30 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.23 Median $0.23 Typical High $0.30 | Professional | RR · Rental | $0.23 | $0.23 | $0.30 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.70 Median $1.70 Typical High $1.82 | Professional | UE · Used equipment | $1.70 | $1.70 | $1.82 |
Where Virginia sits
The same service costs 2.1 times more in Montana 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· 20th of 51
$2.95
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.