How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $3.47 Median $3.47 Typical High $3.80 | Facility | None | $3.47 | $3.47 | $3.80 |
Aetna Setting Professional Modifier None Typical Low $2.75 Median $3.47 Typical High $3.80 | Professional | None | $2.75 | $3.47 | $3.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.07 Median $4.17 Typical High $5.37 | Professional | None | $4.07 | $4.17 | $5.37 |
Cigna Setting Facility Modifier None Typical Low $3.89 Median $6.46 Typical High $9.33 | Facility | None | $3.89 | $6.46 | $9.33 |
Cigna Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | None | $3.72 | $3.72 | $3.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.37 Median $5.62 Typical High $6.31 | Professional | None | $4.37 | $5.62 | $6.31 |
Medcost Setting Facility Modifier None Typical Low $5.25 Median $20.42 Typical High $20.42 | Facility | None | $5.25 | $20.42 | $20.42 |
Medcost Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | None | $2.88 | $2.88 | $2.88 |
United Setting Professional Modifier None Typical Low $2.57 Median $2.63 Typical High $9.55 | Professional | None | $2.57 | $2.63 | $9.55 |
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 52 · Reduced service Typical Low $1.38 Median $1.74 Typical High $1.91 | Professional | 52 · Reduced service | $1.38 | $1.74 | $1.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.55 Median $0.69 Typical High $0.76 | Professional | 53 · Discontinued | $0.55 | $0.69 | $0.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.41 Median $0.52 Typical High $0.56 | Professional | 55 · Aftercare only | $0.41 | $0.52 | $0.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.27 Median $0.35 Typical High $0.38 | Professional | 56 · Pre-op care only | $0.27 | $0.35 | $0.38 |
Where Virginia sits
The same service costs 4.6 times more in Ohio than in Hawaii. 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· 28th of 51
$3.80
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.