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 $0.27 Median $0.27 Typical High $0.28 | Facility | None | $0.27 | $0.27 | $0.28 |
Aetna Setting Professional Modifier None Typical Low $0.23 Median $0.27 Typical High $0.28 | Professional | None | $0.23 | $0.27 | $0.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.18 Median $0.18 Typical High $0.22 | Professional | None | $0.18 | $0.18 | $0.22 |
CareFirst Setting Professional Modifier None Typical Low $0.23 Median $0.23 Typical High $0.24 | Professional | None | $0.23 | $0.23 | $0.24 |
Cigna Setting Facility Modifier None Typical Low $0.19 Median $0.20 Typical High $0.20 | Facility | None | $0.19 | $0.20 | $0.20 |
Cigna Setting Professional Modifier None Typical Low $0.17 Median $0.17 Typical High $0.20 | Professional | None | $0.17 | $0.17 | $0.20 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.31 Median $0.39 Typical High $0.49 | Professional | None | $0.31 | $0.39 | $0.49 |
Medcost Setting Facility Modifier None Typical Low $0.25 Median $0.25 Typical High $0.31 | Facility | None | $0.25 | $0.25 | $0.31 |
Medcost Setting Professional Modifier None Typical Low $0.25 Median $0.27 Typical High $0.30 | Professional | None | $0.25 | $0.27 | $0.30 |
Sentara Setting Facility Modifier None Typical Low $0.13 Median $0.26 Typical High $0.58 | Facility | None | $0.13 | $0.26 | $0.58 |
Sentara Setting Professional Modifier None Typical Low $0.19 Median $0.27 Typical High $0.48 | Professional | None | $0.19 | $0.27 | $0.48 |
United Setting Professional Modifier None Typical Low $0.14 Median $0.17 Typical High $0.26 | Professional | None | $0.14 | $0.17 | $0.26 |
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 |
|---|---|---|---|---|---|
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.13 Median $0.13 Typical High $0.14 | Professional | UE · Used equipment | $0.13 | $0.13 | $0.14 |
Kaiser Permanente Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $0.25 Median $0.30 Typical High $0.44 | Professional | AU · Urologic/ostomy supply | $0.25 | $0.30 | $0.44 |
Kaiser Permanente Setting Professional Modifier AV · With prosthetic/orthotic Typical Low $0.22 Median $0.32 Typical High $0.42 | Professional | AV · With prosthetic/orthotic | $0.22 | $0.32 | $0.42 |
Medcost Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $0.15 Median $0.21 Typical High $0.21 | Professional | AU · Urologic/ostomy supply | $0.15 | $0.21 | $0.21 |
Sentara Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $0.22 Median $0.27 Typical High $0.46 | Professional | AU · Urologic/ostomy supply | $0.22 | $0.27 | $0.46 |
Sentara Setting Professional Modifier AV · With prosthetic/orthotic Typical Low $0.23 Median $0.28 Typical High $0.47 | Professional | AV · With prosthetic/orthotic | $0.23 | $0.28 | $0.47 |
Where Virginia sits
The same service costs 2.7 times more in Arkansas than in Utah. 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· 26th of 51
$0.22
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.