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 $1.10 Median $1.10 Typical High $1.20 | Facility | None | $1.10 | $1.10 | $1.20 |
Aetna Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $1.20 | Professional | None | $1.10 | $1.10 | $1.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.55 Median $0.55 Typical High $0.60 | Professional | 52 · Reduced service | $0.55 | $0.55 | $0.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.22 Median $0.22 Typical High $0.24 | Professional | 53 · Discontinued | $0.22 | $0.22 | $0.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.17 Median $0.17 Typical High $0.18 | Professional | 55 · Aftercare only | $0.17 | $0.17 | $0.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.11 Typical High $0.12 | Professional | 56 · Pre-op care only | $0.11 | $0.11 | $0.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.71 Median $1.00 Typical High $1.35 | Professional | None | $0.71 | $1.00 | $1.35 |
CareFirst Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | None | $1.00 | $1.00 | $1.00 |
Cigna Setting Facility Modifier None Typical Low $1.07 Median $1.07 Typical High $1.07 | Facility | None | $1.07 | $1.07 | $1.07 |
Cigna Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $0.89 | Professional | None | $0.89 | $0.89 | $0.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.51 Median $1.95 Typical High $2.88 | Professional | None | $1.51 | $1.95 | $2.88 |
Medcost Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.78 | Professional | None | $1.29 | $1.29 | $1.78 |
Medcost Setting Facility Modifier None Typical Low $1.10 Median $2.00 Typical High $2.63 | Facility | None | $1.10 | $2.00 | $2.63 |
Medcost Setting Professional Modifier None Typical Low $0.98 Median $0.98 Typical High $1.35 | Professional | None | $0.98 | $0.98 | $1.35 |
Sentara Setting Facility Modifier None Typical Low $1.29 Median $2.45 Typical High $10,232.93 | Facility | None | $1.29 | $2.45 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1.02 Median $1.41 Typical High $2.88 | Professional | None | $1.02 | $1.41 | $2.88 |
United Setting Professional Modifier None Typical Low $0.79 Median $0.87 Typical High $1.35 | Professional | None | $0.79 | $0.87 | $1.35 |
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 $0.35 Median $0.59 Typical High $1.05 | Professional | UE · Used equipment | $0.35 | $0.59 | $1.05 |
Where Virginia sits
The same service costs 2.5 times more in Idaho 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· 26th of 51
$1.07
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.