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 $1.95 Median $3.89 Typical High $15.85 | Facility | None | $1.95 | $3.89 | $15.85 |
Aetna Setting Professional Modifier None Typical Low $3.89 Median $4.07 Typical High $4.37 | Professional | None | $3.89 | $4.07 | $4.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | None | $3.89 | $3.89 | $3.89 |
CareFirst Setting Professional Modifier None Typical Low $3.80 Median $3.80 Typical High $10.47 | Professional | None | $3.80 | $3.80 | $10.47 |
Cigna Setting Facility Modifier None Typical Low $5.75 Median $7.41 Typical High $10.23 | Facility | None | $5.75 | $7.41 | $10.23 |
Cigna Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | None | $3.89 | $3.89 | $3.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.31 Median $4.07 Typical High $4.68 | Professional | None | $3.31 | $4.07 | $4.68 |
Medcost Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | None | $3.89 | $3.89 | $3.89 |
Medcost Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $9.77 | Facility | None | $7.08 | $7.08 | $9.77 |
Sentara Setting Facility Modifier None Typical Low $3.98 Median $6.31 Typical High $6.76 | Facility | None | $3.98 | $6.31 | $6.76 |
Sentara Setting Professional Modifier None Typical Low $3.98 Median $6.31 Typical High $6.76 | Professional | None | $3.98 | $6.31 | $6.76 |
United Setting Professional Modifier None Typical Low $10.00 Median $10.47 Typical High $10.47 | Professional | None | $10.00 | $10.47 | $10.47 |
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 $1.95 Median $2.00 Typical High $2.04 | Professional | 52 · Reduced service | $1.95 | $2.00 | $2.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.78 Median $0.79 Typical High $0.81 | Professional | 53 · Discontinued | $0.78 | $0.79 | $0.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.59 Median $0.59 Typical High $0.62 | Professional | 55 · Aftercare only | $0.59 | $0.59 | $0.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.39 Median $0.40 Typical High $0.41 | Professional | 56 · Pre-op care only | $0.39 | $0.40 | $0.41 |
Where Virginia sits
The same service costs 3.2 times more in Hawaii than in Georgia. 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· 50th of 51
$4.07
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.