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 $1.78 Median $1.78 Typical High $1.95 | Facility | None | $1.78 | $1.78 | $1.95 |
Aetna Setting Professional Modifier None Typical Low $1.48 Median $1.78 Typical High $1.95 | Professional | None | $1.48 | $1.78 | $1.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.55 Median $2.04 Typical High $3.09 | Professional | None | $1.55 | $2.04 | $3.09 |
CareFirst Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $2.04 | Professional | None | $1.78 | $1.78 | $2.04 |
Cigna Setting Facility Modifier None Typical Low $1.74 Median $1.74 Typical High $2.14 | Facility | None | $1.74 | $1.74 | $2.14 |
Cigna Setting Professional Modifier None Typical Low $1.48 Median $1.48 Typical High $1.74 | Professional | None | $1.48 | $1.48 | $1.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.04 Median $2.95 Typical High $3.80 | Professional | None | $2.04 | $2.95 | $3.80 |
Medcost Setting Professional Modifier None Typical Low $1.86 Median $2.09 Typical High $2.88 | Professional | None | $1.86 | $2.09 | $2.88 |
Medcost Setting Facility Modifier None Typical Low $0.87 Median $1.58 Typical High $2.09 | Facility | None | $0.87 | $1.58 | $2.09 |
Medcost Setting Professional Modifier None Typical Low $1.58 Median $1.78 Typical High $2.00 | Professional | None | $1.58 | $1.78 | $2.00 |
Sentara Setting Facility Modifier None Typical Low $1.48 Median $2.19 Typical High $6.31 | Facility | None | $1.48 | $2.19 | $6.31 |
Sentara Setting Professional Modifier None Typical Low $1.91 Median $2.29 Typical High $4.47 | Professional | None | $1.91 | $2.29 | $4.47 |
United Setting Professional Modifier None Typical Low $1.29 Median $1.45 Typical High $2.19 | Professional | None | $1.29 | $1.45 | $2.19 |
6 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 52 · Reduced service Typical Low $0.89 Median $0.89 Typical High $0.98 | Professional | 52 · Reduced service | $0.89 | $0.89 | $0.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.36 Median $0.36 Typical High $0.39 | Professional | 53 · Discontinued | $0.36 | $0.36 | $0.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.27 Median $0.27 Typical High $0.28 | Professional | 55 · Aftercare only | $0.27 | $0.27 | $0.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.18 Median $0.18 Typical High $0.20 | Professional | 56 · Pre-op care only | $0.18 | $0.18 | $0.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.18 Median $0.18 Typical High $0.20 | Professional | RR · Rental | $0.18 | $0.18 | $0.20 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.38 Median $1.38 Typical High $1.48 | Professional | UE · Used equipment | $1.38 | $1.38 | $1.48 |
Where Virginia sits
The same service costs 2.2 times more in Kansas than in Alabama. 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· 37th of 51
$1.78
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.