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 $1.51 Median $1.51 Typical High $1.66 | Facility | None | $1.51 | $1.51 | $1.66 |
Aetna Setting Professional Modifier None Typical Low $1.51 Median $1.51 Typical High $1.66 | Professional | None | $1.51 | $1.51 | $1.66 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.76 Median $0.76 Typical High $0.83 | Professional | 52 · Reduced service | $0.76 | $0.76 | $0.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | None | $1.29 | $1.29 | $1.29 |
CareFirst Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $1.38 | Professional | None | $1.38 | $1.38 | $1.38 |
Cigna Setting Facility Modifier None Typical Low $1.29 Median $1.29 Typical High $1.29 | Facility | None | $1.29 | $1.29 | $1.29 |
Cigna Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $1.12 | Professional | None | $1.02 | $1.02 | $1.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.00 Median $2.63 Typical High $3.72 | Professional | None | $2.00 | $2.63 | $3.72 |
Medcost Setting Facility Modifier None Typical Low $1.51 Median $1.51 Typical High $3.63 | Facility | None | $1.51 | $1.51 | $3.63 |
Medcost Setting Professional Modifier None Typical Low $1.51 Median $1.51 Typical High $7.08 | Professional | None | $1.51 | $1.51 | $7.08 |
Sentara Setting Facility Modifier None Typical Low $2.04 Median $4.07 Typical High $10,232.93 | Facility | None | $2.04 | $4.07 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1.41 Median $2.45 Typical High $10.00 | Professional | None | $1.41 | $2.45 | $10.00 |
United Setting Professional Modifier None Typical Low $1.15 Median $1.23 Typical High $1.95 | Professional | None | $1.15 | $1.23 | $1.95 |
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 $0.30 Median $0.30 Typical High $0.33 | Professional | 53 · Discontinued | $0.30 | $0.30 | $0.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.23 Median $0.23 Typical High $0.25 | Professional | 55 · Aftercare only | $0.23 | $0.23 | $0.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.15 Median $0.15 Typical High $0.17 | Professional | 56 · Pre-op care only | $0.15 | $0.15 | $0.17 |
Where Virginia sits
The same service costs 4.6 times more in Rhode Island 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· 36th of 51
$1.29
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.