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 $0.76 Median $1.07 Typical High $1.51 | Facility | None | $0.76 | $1.07 | $1.51 |
Aetna Setting Professional Modifier None Typical Low $0.76 Median $0.98 Typical High $1.51 | Professional | None | $0.76 | $0.98 | $1.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.63 Median $0.76 Typical High $0.76 | Professional | None | $0.63 | $0.76 | $0.76 |
CareFirst Setting Professional Modifier None Typical Low $0.69 Median $0.85 Typical High $0.85 | Professional | None | $0.69 | $0.85 | $0.85 |
Cigna Setting Facility Modifier None Typical Low $1.10 Median $1.41 Typical High $1.95 | Facility | None | $1.10 | $1.41 | $1.95 |
Cigna Setting Professional Modifier None Typical Low $0.76 Median $0.76 Typical High $0.76 | Professional | None | $0.76 | $0.76 | $0.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.65 Median $0.79 Typical High $1.95 | Professional | None | $0.65 | $0.79 | $1.95 |
Medcost Setting Professional Modifier None Typical Low $2.09 Median $2.09 Typical High $2.09 | Professional | None | $2.09 | $2.09 | $2.09 |
Medcost Setting Facility Modifier None Typical Low $1.23 Median $1.23 Typical High $1.62 | Facility | None | $1.23 | $1.23 | $1.62 |
Sentara Setting Facility Modifier None Typical Low $0.78 Median $1.26 Typical High $1.35 | Facility | None | $0.78 | $1.26 | $1.35 |
Sentara Setting Professional Modifier None Typical Low $0.78 Median $1.26 Typical High $1.35 | Professional | None | $0.78 | $1.26 | $1.35 |
United Setting Professional Modifier None Typical Low $0.69 Median $0.72 Typical High $0.89 | Professional | None | $0.69 | $0.72 | $0.89 |
3 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 $0.38 Median $0.38 Typical High $0.40 | Professional | 52 · Reduced service | $0.38 | $0.38 | $0.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.15 Median $0.15 Typical High $0.16 | Professional | 53 · Discontinued | $0.15 | $0.15 | $0.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.11 Median $0.11 Typical High $0.12 | Professional | 55 · Aftercare only | $0.11 | $0.11 | $0.12 |
Where Virginia sits
The same service costs 5.2 times more in Vermont than in Rhode Island. 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· 33rd of 51
$0.79
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.