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 $2.95 Median $2.95 Typical High $3.24 | Facility | None | $2.95 | $2.95 | $3.24 |
Aetna Setting Professional Modifier None Typical Low $2.45 Median $2.95 Typical High $3.24 | Professional | None | $2.45 | $2.95 | $3.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.57 Median $3.39 Typical High $5.01 | Professional | None | $2.57 | $3.39 | $5.01 |
CareFirst Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $3.31 | Professional | None | $2.88 | $2.88 | $3.31 |
Cigna Setting Facility Modifier None Typical Low $2.69 Median $2.82 Typical High $2.82 | Facility | None | $2.69 | $2.82 | $2.82 |
Cigna Setting Professional Modifier None Typical Low $2.40 Median $2.40 Typical High $2.82 | Professional | None | $2.40 | $2.40 | $2.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.39 Median $4.79 Typical High $6.31 | Professional | None | $3.39 | $4.79 | $6.31 |
Medcost Setting Professional Modifier None Typical Low $3.02 Median $3.39 Typical High $4.68 | Professional | None | $3.02 | $3.39 | $4.68 |
Medcost Setting Facility Modifier None Typical Low $1.41 Median $2.57 Typical High $3.39 | Facility | None | $1.41 | $2.57 | $3.39 |
Medcost Setting Professional Modifier None Typical Low $2.57 Median $2.95 Typical High $3.16 | Professional | None | $2.57 | $2.95 | $3.16 |
Sentara Setting Facility Modifier None Typical Low $2.40 Median $3.55 Typical High $10.47 | Facility | None | $2.40 | $3.55 | $10.47 |
Sentara Setting Professional Modifier None Typical Low $3.09 Median $3.72 Typical High $7.41 | Professional | None | $3.09 | $3.72 | $7.41 |
United Setting Professional Modifier None Typical Low $2.14 Median $2.34 Typical High $3.55 | Professional | None | $2.14 | $2.34 | $3.55 |
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 $1.48 Median $1.48 Typical High $1.58 | Professional | 52 · Reduced service | $1.48 | $1.48 | $1.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.59 Median $0.59 Typical High $0.65 | Professional | 53 · Discontinued | $0.59 | $0.59 | $0.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.44 Median $0.44 Typical High $0.48 | Professional | 55 · Aftercare only | $0.44 | $0.44 | $0.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $0.32 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $0.32 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.30 Median $0.30 Typical High $0.33 | Professional | RR · Rental | $0.30 | $0.30 | $0.33 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.24 Median $2.24 Typical High $2.45 | Professional | UE · Used equipment | $2.24 | $2.24 | $2.45 |
Where Virginia sits
The same service costs 2.2 times more in Kansas than in New Jersey. 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
$2.95
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.