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 $4.37 Median $4.57 Typical High $8.13 | Facility | None | $4.37 | $4.57 | $8.13 |
Aetna Setting Professional Modifier None Typical Low $4.37 Median $4.47 Typical High $4.57 | Professional | None | $4.37 | $4.47 | $4.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.27 Median $8.91 Typical High $14.45 | Facility | None | $4.27 | $8.91 | $14.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.72 Median $4.37 Typical High $4.37 | Professional | None | $3.72 | $4.37 | $4.37 |
CareFirst Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $4.27 | Professional | None | $3.98 | $3.98 | $4.27 |
Cigna Setting Facility Modifier None Typical Low $6.46 Median $8.32 Typical High $11.48 | Facility | None | $6.46 | $8.32 | $11.48 |
Cigna Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | None | $4.37 | $4.37 | $4.37 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.72 Median $4.57 Typical High $6.46 | Professional | None | $3.72 | $4.57 | $6.46 |
Medcost Setting Facility Modifier None Typical Low $4.27 Median $4.27 Typical High $5.75 | Facility | None | $4.27 | $4.27 | $5.75 |
Sentara Setting Facility Modifier None Typical Low $4.47 Median $6.03 Typical High $6.31 | Facility | None | $4.47 | $6.03 | $6.31 |
Sentara Setting Professional Modifier None Typical Low $4.47 Median $6.03 Typical High $6.31 | Professional | None | $4.47 | $6.03 | $6.31 |
United Setting Facility Modifier None Typical Low $4.37 Median $4.37 Typical High $4.37 | Facility | None | $4.37 | $4.37 | $4.37 |
United Setting Professional Modifier None Typical Low $4.07 Median $4.27 Typical High $4.47 | Professional | None | $4.07 | $4.27 | $4.47 |
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 $2.19 Median $2.24 Typical High $2.29 | Professional | 52 · Reduced service | $2.19 | $2.24 | $2.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.87 Median $0.89 Typical High $0.91 | Professional | 53 · Discontinued | $0.87 | $0.89 | $0.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.66 Median $0.66 Typical High $0.69 | Professional | 55 · Aftercare only | $0.66 | $0.66 | $0.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.44 Median $0.44 Typical High $0.46 | Professional | 56 · Pre-op care only | $0.44 | $0.44 | $0.46 |
Where Virginia sits
The same service costs 2.7 times more in Alaska than in Oklahoma. 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· 31st of 51
$4.37
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.