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 $0.54 Median $0.54 Typical High $0.60 | Facility | None | $0.54 | $0.54 | $0.60 |
Aetna Setting Professional Modifier None Typical Low $0.54 Median $0.54 Typical High $0.60 | Professional | None | $0.54 | $0.54 | $0.60 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.27 Median $0.27 Typical High $0.30 | Professional | 52 · Reduced service | $0.27 | $0.27 | $0.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.11 Median $0.11 Typical High $0.12 | Professional | 53 · Discontinued | $0.11 | $0.11 | $0.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.08 Median $0.08 Typical High $0.09 | Professional | 55 · Aftercare only | $0.08 | $0.08 | $0.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.05 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.05 | $0.05 | $0.06 |
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 $0.48 Median $0.48 Typical High $0.48 | Professional | None | $0.48 | $0.48 | $0.48 |
Cigna Setting Facility Modifier None Typical Low $0.52 Median $0.52 Typical High $0.52 | Facility | None | $0.52 | $0.52 | $0.52 |
Cigna Setting Professional Modifier None Typical Low $0.45 Median $0.45 Typical High $0.45 | Professional | None | $0.45 | $0.45 | $0.45 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.78 Median $1.00 Typical High $1.41 | Professional | None | $0.78 | $1.00 | $1.41 |
Medcost Setting Professional Modifier None Typical Low $0.62 Median $0.62 Typical High $0.85 | Professional | None | $0.62 | $0.62 | $0.85 |
Medcost Setting Facility Modifier None Typical Low $0.54 Median $0.95 Typical High $1.29 | Facility | None | $0.54 | $0.95 | $1.29 |
Medcost Setting Professional Modifier None Typical Low $0.48 Median $0.48 Typical High $0.65 | Professional | None | $0.48 | $0.48 | $0.65 |
Sentara Setting Facility Modifier None Typical Low $0.62 Median $1.12 Typical High $10,232.93 | Facility | None | $0.62 | $1.12 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $0.51 Median $0.68 Typical High $1.38 | Professional | None | $0.51 | $0.68 | $1.38 |
United Setting Professional Modifier None Typical Low $0.38 Median $0.44 Typical High $0.65 | Professional | None | $0.38 | $0.44 | $0.65 |
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 $0.17 Median $0.38 Typical High $0.51 | Professional | UE · Used equipment | $0.17 | $0.38 | $0.51 |
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
$0.52
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.