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 $6.76 Median $11.48 Typical High $47.86 | Facility | None | $6.76 | $11.48 | $47.86 |
Aetna Setting Professional Modifier None Typical Low $6.76 Median $7.08 Typical High $7.59 | Professional | None | $6.76 | $7.08 | $7.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.75 Median $6.76 Typical High $6.76 | Professional | None | $5.75 | $6.76 | $6.76 |
CareFirst Setting Professional Modifier None Typical Low $7.24 Median $8.51 Typical High $8.51 | Professional | None | $7.24 | $8.51 | $8.51 |
Cigna Setting Facility Modifier None Typical Low $9.77 Median $12.88 Typical High $17.38 | Facility | None | $9.77 | $12.88 | $17.38 |
Cigna Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | None | $6.76 | $6.76 | $6.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5.75 Median $7.08 Typical High $50.12 | Professional | None | $5.75 | $7.08 | $50.12 |
Medcost Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Medcost Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
Sentara Setting Facility Modifier None Typical Low $6.92 Median $42.66 Typical High $45.71 | Facility | None | $6.92 | $42.66 | $45.71 |
Sentara Setting Professional Modifier None Typical Low $6.92 Median $42.66 Typical High $45.71 | Professional | None | $6.92 | $42.66 | $45.71 |
United Setting Professional Modifier None Typical Low $7.08 Median $7.24 Typical High $7.59 | Professional | None | $7.08 | $7.24 | $7.59 |
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 $3.39 Median $3.39 Typical High $3.55 | Professional | 52 · Reduced service | $3.39 | $3.39 | $3.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.35 Median $1.35 Typical High $1.41 | Professional | 53 · Discontinued | $1.35 | $1.35 | $1.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.00 Median $1.02 Typical High $1.07 | Professional | 55 · Aftercare only | $1.00 | $1.02 | $1.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.68 Median $0.68 Typical High $0.71 | Professional | 56 · Pre-op care only | $0.68 | $0.68 | $0.71 |
Where Virginia sits
The same service costs 6.0 times more in Wyoming 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· 49th of 51
$7.08
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.