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 $1.23 Median $1.23 Typical High $2.24 | Facility | None | $1.23 | $1.23 | $2.24 |
Aetna Setting Professional Modifier None Typical Low $1.23 Median $1.23 Typical High $2.24 | Professional | None | $1.23 | $1.23 | $2.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.04 Median $2.04 Typical High $2.19 | Facility | None | $2.04 | $2.04 | $2.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.51 Median $1.58 Typical High $1.58 | Professional | None | $1.51 | $1.58 | $1.58 |
CareFirst Setting Professional Modifier None Typical Low $2.09 Median $2.09 Typical High $2.09 | Professional | None | $2.09 | $2.09 | $2.09 |
Cigna Setting Facility Modifier None Typical Low $1.38 Median $1.38 Typical High $3.09 | Facility | None | $1.38 | $1.38 | $3.09 |
Cigna Setting Professional Modifier None Typical Low $1.17 Median $1.70 Typical High $1.70 | Professional | None | $1.17 | $1.70 | $1.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.91 Median $2.63 Typical High $4.07 | Professional | None | $1.91 | $2.63 | $4.07 |
Medcost Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | None | $3.72 | $3.72 | $3.72 |
Medcost Setting Facility Modifier None Typical Low $1.32 Median $2.40 Typical High $2.51 | Facility | None | $1.32 | $2.40 | $2.51 |
Medcost Setting Professional Modifier None Typical Low $1.23 Median $1.23 Typical High $1.66 | Professional | None | $1.23 | $1.23 | $1.66 |
Sentara Setting Facility Modifier None Typical Low $1.15 Median $1.95 Typical High $4.47 | Facility | None | $1.15 | $1.95 | $4.47 |
Sentara Setting Professional Modifier None Typical Low $1.15 Median $1.95 Typical High $6.03 | Professional | None | $1.15 | $1.95 | $6.03 |
United Setting Professional Modifier None Typical Low $1.15 Median $3.16 Typical High $3.55 | Professional | None | $1.15 | $3.16 | $3.55 |
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 $0.19 Median $0.19 Typical High $0.34 | Professional | 55 · Aftercare only | $0.19 | $0.19 | $0.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.12 Median $0.12 Typical High $0.23 | Professional | 56 · Pre-op care only | $0.12 | $0.12 | $0.23 |
Where Virginia sits
The same service costs 33.1 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· 35th of 51
$1.91
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.