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 $3.09 Median $3.09 Typical High $3.39 | Facility | None | $3.09 | $3.09 | $3.39 |
Aetna Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $3.39 | Professional | None | $3.09 | $3.09 | $3.39 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.75 Median $3.72 Typical High $5.50 | Professional | None | $2.75 | $3.72 | $5.50 |
CareFirst Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $3.47 | Professional | None | $3.09 | $3.09 | $3.47 |
Cigna Setting Facility Modifier None Typical Low $3.02 Median $3.02 Typical High $3.72 | Facility | None | $3.02 | $3.02 | $3.72 |
Cigna Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $3.02 | Professional | None | $2.57 | $2.57 | $3.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.55 Median $5.13 Typical High $6.61 | Professional | None | $3.55 | $5.13 | $6.61 |
Medcost Setting Professional Modifier None Typical Low $2.51 Median $3.55 Typical High $3.55 | Professional | None | $2.51 | $3.55 | $3.55 |
Medcost Setting Facility Modifier None Typical Low $1.51 Median $2.75 Typical High $3.55 | Facility | None | $1.51 | $2.75 | $3.55 |
Medcost Setting Professional Modifier None Typical Low $2.75 Median $3.09 Typical High $3.80 | Professional | None | $2.75 | $3.09 | $3.80 |
Sentara Setting Facility Modifier None Typical Low $2.51 Median $3.89 Typical High $14.79 | Facility | None | $2.51 | $3.89 | $14.79 |
Sentara Setting Professional Modifier None Typical Low $3.31 Median $4.07 Typical High $8.32 | Professional | None | $3.31 | $4.07 | $8.32 |
United Setting Professional Modifier None Typical Low $2.24 Median $2.51 Typical High $3.80 | Professional | None | $2.24 | $2.51 | $3.80 |
4 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 55 · Aftercare only Typical Low $0.46 Median $0.46 Typical High $0.51 | Professional | 55 · Aftercare only | $0.46 | $0.46 | $0.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.31 Median $0.31 Typical High $0.34 | Professional | 56 · Pre-op care only | $0.31 | $0.31 | $0.34 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.33 Median $0.33 Typical High $0.36 | Professional | RR · Rental | $0.33 | $0.33 | $0.36 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.45 Median $2.45 Typical High $2.63 | Professional | UE · Used equipment | $2.45 | $2.45 | $2.63 |
Where Virginia sits
The same service costs 2.2 times more in Kansas than in Delaware. 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
$3.09
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.