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 $1.10 Median $1.10 Typical High $1.12 | Facility | None | $1.10 | $1.10 | $1.12 |
Aetna Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $1.12 | Professional | None | $1.10 | $1.10 | $1.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $1.10 | Professional | None | $1.10 | $1.10 | $1.10 |
CareFirst Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $1.02 | Professional | None | $1.02 | $1.02 | $1.02 |
Cigna Setting Facility Modifier None Typical Low $1.58 Median $2.04 Typical High $2.82 | Facility | None | $1.58 | $2.04 | $2.82 |
Cigna Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $1.10 | Professional | None | $1.10 | $1.10 | $1.10 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.93 Median $1.12 Typical High $3.09 | Professional | None | $0.93 | $1.12 | $3.09 |
Medcost Setting Facility Modifier None Typical Low $1.02 Median $1.02 Typical High $3.24 | Facility | None | $1.02 | $1.02 | $3.24 |
Medcost Setting Professional Modifier None Typical Low $1.02 Median $2.04 Typical High $3.47 | Professional | None | $1.02 | $2.04 | $3.47 |
Sentara Setting Facility Modifier None Typical Low $1.10 Median $3.09 Typical High $3.31 | Facility | None | $1.10 | $3.09 | $3.31 |
Sentara Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $3.31 | Professional | None | $1.10 | $1.10 | $3.31 |
United Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $1.07 | Professional | None | $1.02 | $1.02 | $1.07 |
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 $0.55 Median $0.55 Typical High $0.56 | Professional | 52 · Reduced service | $0.55 | $0.55 | $0.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.22 Median $0.22 Typical High $0.23 | Professional | 53 · Discontinued | $0.22 | $0.22 | $0.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.16 Median $0.16 Typical High $0.17 | Professional | 55 · Aftercare only | $0.16 | $0.16 | $0.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.11 Typical High $0.11 | Professional | 56 · Pre-op care only | $0.11 | $0.11 | $0.11 |
Where Virginia sits
The same service costs 2.7 times more in Wyoming than in Alabama. 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· 20th of 51
$1.10
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.