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 $1.62 Median $1.62 Typical High $1.78 | Facility | None | $1.62 | $1.62 | $1.78 |
Aetna Setting Professional Modifier None Typical Low $1.62 Median $1.62 Typical High $1.78 | Professional | None | $1.62 | $1.62 | $1.78 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.81 Median $0.81 Typical High $0.89 | Professional | 52 · Reduced service | $0.81 | $0.81 | $0.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.32 Median $0.32 Typical High $0.35 | Professional | 53 · Discontinued | $0.32 | $0.32 | $0.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.24 Median $0.24 Typical High $0.27 | Professional | 55 · Aftercare only | $0.24 | $0.24 | $0.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.16 Median $0.16 Typical High $0.18 | Professional | 56 · Pre-op care only | $0.16 | $0.16 | $0.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.05 Median $1.51 Typical High $2.00 | Professional | None | $1.05 | $1.51 | $2.00 |
CareFirst Setting Professional Modifier None Typical Low $1.48 Median $1.48 Typical High $1.48 | Professional | None | $1.48 | $1.48 | $1.48 |
Cigna Setting Facility Modifier None Typical Low $1.58 Median $1.58 Typical High $1.58 | Facility | None | $1.58 | $1.58 | $1.58 |
Cigna Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.32 | Professional | None | $1.32 | $1.32 | $1.32 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.24 Median $2.95 Typical High $4.27 | Professional | None | $2.24 | $2.95 | $4.27 |
Medcost Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $2.63 | Professional | None | $1.86 | $1.86 | $2.63 |
Medcost Setting Facility Modifier None Typical Low $1.62 Median $2.95 Typical High $3.89 | Facility | None | $1.62 | $2.95 | $3.89 |
Medcost Setting Professional Modifier None Typical Low $1.45 Median $1.45 Typical High $1.95 | Professional | None | $1.45 | $1.45 | $1.95 |
Sentara Setting Facility Modifier None Typical Low $1.86 Median $3.63 Typical High $10,232.93 | Facility | None | $1.86 | $3.63 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1.51 Median $2.09 Typical High $4.37 | Professional | None | $1.51 | $2.09 | $4.37 |
United Setting Professional Modifier None Typical Low $1.17 Median $1.32 Typical High $1.95 | Professional | None | $1.17 | $1.32 | $1.95 |
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 |
|---|---|---|---|---|---|
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.52 Median $0.95 Typical High $1.51 | Professional | UE · Used equipment | $0.52 | $0.95 | $1.51 |
Where Virginia sits
The same service costs 2.6 times more in Hawaii than in Colorado. 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· 24th of 51
$1.58
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.