How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $0.12 Median $0.12 Typical High $0.15 | Facility | None | $0.12 | $0.12 | $0.15 |
Aetna Setting Professional Modifier None Typical Low $0.12 Median $0.12 Typical High $0.15 | Professional | None | $0.12 | $0.12 | $0.15 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.06 Median $0.06 Typical High $0.08 | Professional | 52 · Reduced service | $0.06 | $0.06 | $0.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.02 Median $0.02 Typical High $0.03 | Professional | 53 · Discontinued | $0.02 | $0.02 | $0.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 55 · Aftercare only | $0.02 | $0.02 | $0.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $26.30 | Professional | None | $25.70 | $25.70 | $26.30 |
Cigna Setting Professional Modifier None Typical Low $0.35 Median $0.35 Typical High $0.35 | Professional | None | $0.35 | $0.35 | $0.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | None | $7.94 | $7.94 | $7.94 |
Medcost Setting Facility Modifier None Typical Low $0.23 Median $0.23 Typical High $0.23 | Facility | None | $0.23 | $0.23 | $0.23 |
Sentara Setting Facility Modifier None Typical Low $7,413.10 Median $10,232.93 Typical High $11,481.54 | Facility | None | $7,413.10 | $10,232.93 | $11,481.54 |
Sentara Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $4,570.88 | Professional | None | $100.00 | $100.00 | $4,570.88 |
1 more rate 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 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 56 · Pre-op care only | $0.02 | $0.02 | $0.02 |
Where Virginia sits
The same service costs 660.7 times more in Montana than in Louisiana. 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· 32nd of 51
$0.35
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.