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 $8.71 Median $8.71 Typical High $11.22 | Facility | None | $8.71 | $8.71 | $11.22 |
Aetna Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $11.22 | Professional | None | $8.71 | $8.71 | $11.22 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $11.22 | Professional | None | $7.24 | $7.24 | $11.22 |
CareFirst Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $11.75 | Professional | None | $11.22 | $11.22 | $11.75 |
Cigna Setting Facility Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Facility | None | $10.00 | $10.00 | $10.00 |
Cigna Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $10.00 | Professional | None | $8.51 | $8.51 | $10.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $11.75 Median $14.45 Typical High $21.38 | Professional | None | $11.75 | $14.45 | $21.38 |
Medcost Setting Professional Modifier None Typical Low $10.72 Median $12.02 Typical High $16.60 | Professional | None | $10.72 | $12.02 | $16.60 |
Medcost Setting Facility Modifier None Typical Low $5.01 Median $7.76 Typical High $12.02 | Facility | None | $5.01 | $7.76 | $12.02 |
Medcost Setting Professional Modifier None Typical Low $7.76 Median $9.33 Typical High $10.00 | Professional | None | $7.76 | $9.33 | $10.00 |
Sentara Setting Facility Modifier None Typical Low $7.24 Median $10.47 Typical High $30.90 | Facility | None | $7.24 | $10.47 | $30.90 |
Sentara Setting Professional Modifier None Typical Low $9.33 Median $11.22 Typical High $23.44 | Professional | None | $9.33 | $11.22 | $23.44 |
United Setting Professional Modifier None Typical Low $6.31 Median $7.59 Typical High $12.02 | Professional | None | $6.31 | $7.59 | $12.02 |
4 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 55 · Aftercare only Typical Low $1.32 Median $1.32 Typical High $1.70 | Professional | 55 · Aftercare only | $1.32 | $1.32 | $1.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.87 Median $0.87 Typical High $1.12 | Professional | 56 · Pre-op care only | $0.87 | $0.87 | $1.12 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.72 Median $0.72 Typical High $1.12 | Professional | RR · Rental | $0.72 | $0.72 | $1.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $5.37 Median $5.50 Typical High $5.75 | Professional | UE · Used equipment | $5.37 | $5.50 | $5.75 |
Where Virginia sits
The same service costs 2.3 times more in Montana than in Connecticut. 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· 35th of 51
$8.71
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.