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 $7.08 Median $9.33 Typical High $12.02 | Facility | None | $7.08 | $9.33 | $12.02 |
Aetna Setting Professional Modifier None Typical Low $7.08 Median $8.71 Typical High $12.02 | Professional | None | $7.08 | $8.71 | $12.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.03 Median $7.08 Typical High $7.08 | Professional | None | $6.03 | $7.08 | $7.08 |
CareFirst Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $6.92 | Professional | None | $6.46 | $6.46 | $6.92 |
Cigna Setting Facility Modifier None Typical Low $10.47 Median $13.49 Typical High $18.62 | Facility | None | $10.47 | $13.49 | $18.62 |
Cigna Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | None | $7.08 | $7.08 | $7.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $6.03 Median $7.41 Typical High $12.02 | Professional | None | $6.03 | $7.41 | $12.02 |
Medcost Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | None | $6.46 | $6.46 | $6.46 |
Medcost Setting Facility Modifier None Typical Low $9.55 Median $9.55 Typical High $12.59 | Facility | None | $9.55 | $9.55 | $12.59 |
Sentara Setting Facility Modifier None Typical Low $7.24 Median $9.77 Typical High $10.47 | Facility | None | $7.24 | $9.77 | $10.47 |
Sentara Setting Professional Modifier None Typical Low $7.24 Median $9.77 Typical High $10.47 | Professional | None | $7.24 | $9.77 | $10.47 |
United Setting Professional Modifier None Typical Low $6.76 Median $6.92 Typical High $7.24 | Professional | None | $6.76 | $6.92 | $7.24 |
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 $3.55 Median $3.63 Typical High $3.72 | Professional | 52 · Reduced service | $3.55 | $3.63 | $3.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.45 Median $1.45 Typical High $1.51 | Professional | 53 · Discontinued | $1.45 | $1.45 | $1.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.07 Median $1.07 Typical High $1.12 | Professional | 55 · Aftercare only | $1.07 | $1.07 | $1.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.71 Median $0.72 Typical High $0.76 | Professional | 56 · Pre-op care only | $0.71 | $0.72 | $0.76 |
Where Virginia sits
The same service costs 2.0 times more in Alaska than in Maryland. 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· 30th of 51
$7.41
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.