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 $5.13 Median $5.13 Typical High $5.37 | Facility | None | $5.13 | $5.13 | $5.37 |
Aetna Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $5.37 | Professional | None | $5.13 | $5.13 | $5.37 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.13 Median $10.47 Typical High $16.60 | Facility | None | $5.13 | $10.47 | $16.60 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.37 Median $5.13 Typical High $5.13 | Professional | None | $4.37 | $5.13 | $5.13 |
CareFirst Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $5.13 | Professional | None | $4.90 | $4.90 | $5.13 |
Cigna Setting Facility Modifier None Typical Low $7.41 Median $9.77 Typical High $13.18 | Facility | None | $7.41 | $9.77 | $13.18 |
Cigna Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | None | $5.13 | $5.13 | $5.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.37 Median $5.37 Typical High $7.59 | Professional | None | $4.37 | $5.37 | $7.59 |
Medcost Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | None | $3.47 | $3.47 | $3.47 |
Medcost Setting Facility Modifier None Typical Low $6.17 Median $6.17 Typical High $8.13 | Facility | None | $6.17 | $6.17 | $8.13 |
Sentara Setting Facility Modifier None Typical Low $5.25 Median $6.31 Typical High $7.08 | Facility | None | $5.25 | $6.31 | $7.08 |
Sentara Setting Professional Modifier None Typical Low $5.25 Median $6.31 Typical High $7.08 | Professional | None | $5.25 | $6.31 | $7.08 |
United Setting Facility Modifier None Typical Low $5.13 Median $5.13 Typical High $5.13 | Facility | None | $5.13 | $5.13 | $5.13 |
United Setting Professional Modifier None Typical Low $5.01 Median $5.13 Typical High $5.37 | Professional | None | $5.01 | $5.13 | $5.37 |
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 $2.57 Median $2.57 Typical High $2.69 | Professional | 52 · Reduced service | $2.57 | $2.57 | $2.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.02 Median $1.05 Typical High $1.07 | Professional | 53 · Discontinued | $1.02 | $1.05 | $1.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.78 Median $0.78 Typical High $0.81 | Professional | 55 · Aftercare only | $0.78 | $0.78 | $0.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.51 Median $0.52 Typical High $0.54 | Professional | 56 · Pre-op care only | $0.51 | $0.52 | $0.54 |
Where Virginia sits
The same service costs 1.7 times more in Arizona than in New Mexico. 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· 43rd of 51
$5.13
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.