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 $3.24 Median $3.24 Typical High $6.03 | Facility | None | $3.24 | $3.24 | $6.03 |
Aetna Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $6.03 | Professional | None | $3.24 | $3.24 | $6.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.37 Median $5.37 Typical High $5.62 | Facility | None | $5.37 | $5.37 | $5.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.27 Median $4.37 Typical High $4.57 | Professional | None | $4.27 | $4.37 | $4.57 |
CareFirst Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | None | $6.76 | $6.76 | $6.76 |
Cigna Setting Facility Modifier None Typical Low $3.09 Median $3.09 Typical High $10.00 | Facility | None | $3.09 | $3.09 | $10.00 |
Cigna Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | None | $2.57 | $2.57 | $2.57 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.57 Median $6.31 Typical High $12.02 | Professional | None | $4.57 | $6.31 | $12.02 |
Medcost Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | None | $12.02 | $12.02 | $12.02 |
Medcost Setting Facility Modifier None Typical Low $3.39 Median $6.46 Typical High $8.13 | Facility | None | $3.39 | $6.46 | $8.13 |
Medcost Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $5.37 | Professional | None | $3.89 | $3.89 | $5.37 |
Sentara Setting Facility Modifier None Typical Low $2.95 Median $5.25 Typical High $11.48 | Facility | None | $2.95 | $5.25 | $11.48 |
Sentara Setting Professional Modifier None Typical Low $2.95 Median $5.37 Typical High $15.49 | Professional | None | $2.95 | $5.37 | $15.49 |
United Setting Professional Modifier None Typical Low $3.24 Median $9.12 Typical High $11.22 | Professional | None | $3.24 | $9.12 | $11.22 |
2 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 $0.48 Median $0.48 Typical High $0.91 | Professional | 55 · Aftercare only | $0.48 | $0.48 | $0.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.32 Median $0.32 Typical High $0.62 | Professional | 56 · Pre-op care only | $0.32 | $0.32 | $0.62 |
Where Virginia sits
The same service costs 4.2 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· 28th of 51
$5.37
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.