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 $8.32 Median $8.32 Typical High $9.12 | Facility | None | $8.32 | $8.32 | $9.12 |
Aetna Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $9.12 | Professional | None | $8.32 | $8.32 | $9.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.61 Median $6.61 Typical High $7.76 | Professional | None | $6.61 | $6.61 | $7.76 |
CareFirst Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $9.33 | Professional | None | $8.71 | $8.71 | $9.33 |
Cigna Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $8.51 | Facility | None | $8.13 | $8.13 | $8.51 |
Cigna Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $8.13 | Professional | None | $6.92 | $6.92 | $8.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $9.55 Median $13.80 Typical High $17.78 | Professional | None | $9.55 | $13.80 | $17.78 |
Medcost Setting Facility Modifier None Typical Low $7.41 Median $7.41 Typical High $9.55 | Facility | None | $7.41 | $7.41 | $9.55 |
Medcost Setting Professional Modifier None Typical Low $7.41 Median $8.32 Typical High $10.47 | Professional | None | $7.41 | $8.32 | $10.47 |
Sentara Setting Facility Modifier None Typical Low $7.41 Median $10.23 Typical High $29.51 | Facility | None | $7.41 | $10.23 | $29.51 |
Sentara Setting Professional Modifier None Typical Low $8.91 Median $10.72 Typical High $20.89 | Professional | None | $8.91 | $10.72 | $20.89 |
United Setting Professional Modifier None Typical Low $5.75 Median $6.76 Typical High $10.23 | Professional | None | $5.75 | $6.76 | $10.23 |
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 $4.17 Median $4.17 Typical High $4.57 | Professional | 52 · Reduced service | $4.17 | $4.17 | $4.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.66 Median $1.66 Typical High $1.82 | Professional | 53 · Discontinued | $1.66 | $1.66 | $1.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.26 Median $1.26 Typical High $1.35 | Professional | 55 · Aftercare only | $1.26 | $1.26 | $1.35 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.83 Median $0.83 Typical High $0.91 | Professional | 56 · Pre-op care only | $0.83 | $0.83 | $0.91 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.71 Median $0.71 Typical High $0.95 | Professional | RR · Rental | $0.71 | $0.71 | $0.95 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.90 Median $5.25 Typical High $5.37 | Professional | UE · Used equipment | $4.90 | $5.25 | $5.37 |
Where Virginia sits
The same service costs 2.2 times more in Hawaii than in Maine. 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· 41st of 51
$7.08
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.