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 $0.35 Median $0.35 Typical High $0.37 | Facility | None | $0.35 | $0.35 | $0.37 |
Aetna Setting Professional Modifier None Typical Low $0.35 Median $0.35 Typical High $0.37 | Professional | None | $0.35 | $0.35 | $0.37 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.18 Median $0.18 Typical High $0.19 | Professional | 52 · Reduced service | $0.18 | $0.18 | $0.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.05 Typical High $0.06 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.06 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.23 Median $0.32 Typical High $0.42 | Professional | None | $0.23 | $0.32 | $0.42 |
CareFirst Setting Professional Modifier None Typical Low $0.32 Median $0.32 Typical High $0.32 | Professional | None | $0.32 | $0.32 | $0.32 |
Cigna Setting Facility Modifier None Typical Low $0.33 Median $0.33 Typical High $0.33 | Facility | None | $0.33 | $0.33 | $0.33 |
Cigna Setting Professional Modifier None Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | None | $0.28 | $0.28 | $0.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.47 Median $0.62 Typical High $0.87 | Professional | None | $0.47 | $0.62 | $0.87 |
Medcost Setting Professional Modifier None Typical Low $0.41 Median $0.41 Typical High $0.58 | Professional | None | $0.41 | $0.41 | $0.58 |
Medcost Setting Facility Modifier None Typical Low $0.35 Median $0.65 Typical High $0.83 | Facility | None | $0.35 | $0.65 | $0.83 |
Medcost Setting Professional Modifier None Typical Low $0.31 Median $0.31 Typical High $0.43 | Professional | None | $0.31 | $0.31 | $0.43 |
Sentara Setting Facility Modifier None Typical Low $0.41 Median $0.76 Typical High $10,232.93 | Facility | None | $0.41 | $0.76 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $0.32 Median $0.45 Typical High $0.89 | Professional | None | $0.32 | $0.45 | $0.89 |
United Setting Professional Modifier None Typical Low $0.26 Median $0.28 Typical High $0.43 | Professional | None | $0.26 | $0.28 | $0.43 |
3 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 53 · Discontinued Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 53 · Discontinued | $0.07 | $0.07 | $0.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.04 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.11 Median $0.25 Typical High $0.35 | Professional | UE · Used equipment | $0.11 | $0.25 | $0.35 |
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· 28th of 51
$0.33
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.