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 $0.59 Median $0.59 Typical High $0.65 | Facility | None | $0.59 | $0.59 | $0.65 |
Aetna Setting Professional Modifier None Typical Low $0.59 Median $0.59 Typical High $0.65 | Professional | None | $0.59 | $0.59 | $0.65 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.30 Median $0.30 Typical High $0.33 | Professional | 52 · Reduced service | $0.30 | $0.30 | $0.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.12 Median $0.12 Typical High $0.13 | Professional | 53 · Discontinued | $0.12 | $0.12 | $0.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.09 Median $0.09 Typical High $0.10 | Professional | 55 · Aftercare only | $0.09 | $0.09 | $0.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.07 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.37 Median $0.54 Typical High $0.71 | Professional | None | $0.37 | $0.54 | $0.71 |
CareFirst Setting Professional Modifier None Typical Low $0.52 Median $0.52 Typical High $0.52 | Professional | None | $0.52 | $0.52 | $0.52 |
Cigna Setting Facility Modifier None Typical Low $0.58 Median $0.58 Typical High $0.58 | Facility | None | $0.58 | $0.58 | $0.58 |
Cigna Setting Professional Modifier None Typical Low $0.49 Median $0.49 Typical High $0.49 | Professional | None | $0.49 | $0.49 | $0.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.81 Median $1.07 Typical High $1.45 | Professional | None | $0.81 | $1.07 | $1.45 |
Medcost Setting Professional Modifier None Typical Low $0.68 Median $0.68 Typical High $0.93 | Professional | None | $0.68 | $0.68 | $0.93 |
Medcost Setting Facility Modifier None Typical Low $0.59 Median $1.05 Typical High $1.41 | Facility | None | $0.59 | $1.05 | $1.41 |
Medcost Setting Professional Modifier None Typical Low $0.52 Median $0.52 Typical High $0.71 | Professional | None | $0.52 | $0.52 | $0.71 |
Sentara Setting Facility Modifier None Typical Low $0.68 Median $1.32 Typical High $10,232.93 | Facility | None | $0.68 | $1.32 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $0.56 Median $0.76 Typical High $1.58 | Professional | None | $0.56 | $0.76 | $1.58 |
United Setting Professional Modifier None Typical Low $0.42 Median $0.48 Typical High $0.71 | Professional | None | $0.42 | $0.48 | $0.71 |
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 $0.19 Median $0.42 Typical High $0.54 | Professional | UE · Used equipment | $0.19 | $0.42 | $0.54 |
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
$0.56
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.