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 $3.98 Median $3.98 Typical High $3.98 | Facility | None | $3.98 | $3.98 | $3.98 |
Aetna Setting Professional Modifier None Typical Low $3.89 Median $3.98 Typical High $3.98 | Professional | None | $3.89 | $3.98 | $3.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | None | $3.98 | $3.98 | $3.98 |
CareFirst Setting Professional Modifier None Typical Low $4.57 Median $4.57 Typical High $4.57 | Professional | None | $4.57 | $4.57 | $4.57 |
Cigna Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | None | $3.98 | $3.98 | $3.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $7.08 Median $10.96 Typical High $12.88 | Professional | None | $7.08 | $10.96 | $12.88 |
Medcost Setting Facility Modifier None Typical Low $4.68 Median $4.68 Typical High $6.03 | Facility | None | $4.68 | $4.68 | $6.03 |
Medcost Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | None | $3.98 | $3.98 | $3.98 |
Sentara Setting Facility Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Facility | None | $5.62 | $5.62 | $5.62 |
Sentara Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | None | $5.62 | $5.62 | $5.62 |
United Setting Professional Modifier None Typical Low $3.80 Median $5.89 Typical High $5.89 | Professional | None | $3.80 | $5.89 | $5.89 |
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 $1.95 Median $2.00 Typical High $2.00 | Professional | 52 · Reduced service | $1.95 | $2.00 | $2.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.78 Median $0.79 Typical High $0.79 | Professional | 53 · Discontinued | $0.78 | $0.79 | $0.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.59 Median $0.60 Typical High $0.60 | Professional | 55 · Aftercare only | $0.59 | $0.60 | $0.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.39 Median $0.40 Typical High $0.40 | Professional | 56 · Pre-op care only | $0.39 | $0.40 | $0.40 |
Where Virginia sits
The same service costs 5.9 times more in Hawaii than in Arkansas. 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· 34th of 51
$3.98
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.