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 $0.48 Median $0.48 Typical High $0.52 | Facility | None | $0.48 | $0.48 | $0.52 |
Aetna Setting Professional Modifier None Typical Low $0.48 Median $0.48 Typical High $0.52 | Professional | None | $0.48 | $0.48 | $0.52 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.24 Median $0.24 Typical High $0.27 | Professional | 52 · Reduced service | $0.24 | $0.24 | $0.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.10 Median $0.10 Typical High $0.11 | Professional | 53 · Discontinued | $0.10 | $0.10 | $0.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.07 Median $0.07 Typical High $0.08 | Professional | 55 · Aftercare only | $0.07 | $0.07 | $0.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.33 Median $0.48 Typical High $0.65 | Professional | None | $0.33 | $0.48 | $0.65 |
CareFirst Setting Professional Modifier None Typical Low $0.44 Median $0.44 Typical High $0.44 | Professional | None | $0.44 | $0.44 | $0.44 |
Cigna Setting Facility Modifier None Typical Low $0.47 Median $0.47 Typical High $0.47 | Facility | None | $0.47 | $0.47 | $0.47 |
Cigna Setting Professional Modifier None Typical Low $0.40 Median $0.40 Typical High $0.40 | Professional | None | $0.40 | $0.40 | $0.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.68 Median $0.87 Typical High $1.29 | Professional | None | $0.68 | $0.87 | $1.29 |
Medcost Setting Professional Modifier None Typical Low $0.56 Median $0.56 Typical High $0.78 | Professional | None | $0.56 | $0.56 | $0.78 |
Medcost Setting Facility Modifier None Typical Low $0.48 Median $0.87 Typical High $1.15 | Facility | None | $0.48 | $0.87 | $1.15 |
Medcost Setting Professional Modifier None Typical Low $0.43 Median $0.43 Typical High $0.59 | Professional | None | $0.43 | $0.43 | $0.59 |
Sentara Setting Facility Modifier None Typical Low $0.56 Median $1.10 Typical High $10,232.93 | Facility | None | $0.56 | $1.10 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $0.46 Median $0.62 Typical High $1.29 | Professional | None | $0.46 | $0.62 | $1.29 |
United Setting Professional Modifier None Typical Low $0.35 Median $0.39 Typical High $0.59 | Professional | None | $0.35 | $0.39 | $0.59 |
2 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 56 · Pre-op care only Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.05 | $0.05 | $0.05 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.17 Median $0.28 Typical High $0.47 | Professional | UE · Used equipment | $0.17 | $0.28 | $0.47 |
Where Virginia sits
The same service costs 2.6 times more in Hawaii 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
$0.48
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.