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 $3.55 Median $3.55 Typical High $3.72 | Facility | None | $3.55 | $3.55 | $3.72 |
Aetna Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.72 | Professional | None | $3.55 | $3.55 | $3.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.55 Median $7.08 Typical High $11.48 | Facility | None | $3.55 | $7.08 | $11.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.02 Median $3.55 Typical High $3.55 | Professional | None | $3.02 | $3.55 | $3.55 |
CareFirst Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.55 | Professional | None | $3.39 | $3.39 | $3.55 |
Cigna Setting Facility Modifier None Typical Low $5.13 Median $6.61 Typical High $9.12 | Facility | None | $5.13 | $6.61 | $9.12 |
Cigna Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.02 Median $3.72 Typical High $4.27 | Professional | None | $3.02 | $3.72 | $4.27 |
Medcost Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $5.62 | Facility | None | $3.55 | $3.55 | $5.62 |
Sentara Setting Facility Modifier None Typical Low $3.31 Median $3.55 Typical High $4.57 | Facility | None | $3.31 | $3.55 | $4.57 |
Sentara Setting Professional Modifier None Typical Low $3.31 Median $3.55 Typical High $4.57 | Professional | None | $3.31 | $3.55 | $4.57 |
United Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Facility | None | $3.55 | $3.55 | $3.55 |
United Setting Professional Modifier None Typical Low $3.39 Median $3.55 Typical High $3.72 | Professional | None | $3.39 | $3.55 | $3.72 |
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 $1.78 Median $1.78 Typical High $1.86 | Professional | 52 · Reduced service | $1.78 | $1.78 | $1.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.71 Median $0.71 Typical High $0.74 | Professional | 53 · Discontinued | $0.71 | $0.71 | $0.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.52 Typical High $0.55 | Professional | 55 · Aftercare only | $0.52 | $0.52 | $0.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.35 Median $0.36 Typical High $0.37 | Professional | 56 · Pre-op care only | $0.35 | $0.36 | $0.37 |
Where Virginia sits
The same service costs 1.7 times more in Arizona than in Illinois. 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· 39th of 51
$3.55
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.