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 $1.12 Median $1.48 Typical High $2.00 | Facility | None | $1.12 | $1.48 | $2.00 |
Aetna Setting Professional Modifier None Typical Low $1.12 Median $1.17 Typical High $1.91 | Professional | None | $1.12 | $1.17 | $1.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.10 Median $2.29 Typical High $3.72 | Facility | None | $1.10 | $2.29 | $3.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.95 Median $1.12 Typical High $1.12 | Professional | None | $0.95 | $1.12 | $1.12 |
CareFirst Setting Professional Modifier None Typical Low $1.07 Median $1.07 Typical High $1.10 | Professional | None | $1.07 | $1.07 | $1.10 |
Cigna Setting Facility Modifier None Typical Low $1.66 Median $2.14 Typical High $2.95 | Facility | None | $1.66 | $2.14 | $2.95 |
Cigna Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | None | $1.12 | $1.12 | $1.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.95 Median $1.20 Typical High $2.82 | Professional | None | $0.95 | $1.20 | $2.82 |
Medcost Setting Facility Modifier None Typical Low $1.10 Median $1.10 Typical High $2.00 | Facility | None | $1.10 | $1.10 | $2.00 |
Sentara Setting Facility Modifier None Typical Low $1.15 Median $2.29 Typical High $2.51 | Facility | None | $1.15 | $2.29 | $2.51 |
Sentara Setting Professional Modifier None Typical Low $1.15 Median $2.29 Typical High $2.51 | Professional | None | $1.15 | $2.29 | $2.51 |
United Setting Facility Modifier None Typical Low $1.12 Median $1.12 Typical High $1.12 | Facility | None | $1.12 | $1.12 | $1.12 |
United Setting Professional Modifier None Typical Low $1.07 Median $1.10 Typical High $1.15 | Professional | None | $1.07 | $1.10 | $1.15 |
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 $0.56 Median $0.56 Typical High $0.60 | Professional | 52 · Reduced service | $0.56 | $0.56 | $0.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.23 Median $0.23 Typical High $0.24 | Professional | 53 · Discontinued | $0.23 | $0.23 | $0.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.17 Median $0.17 Typical High $0.18 | Professional | 55 · Aftercare only | $0.17 | $0.17 | $0.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.11 Typical High $0.12 | Professional | 56 · Pre-op care only | $0.11 | $0.11 | $0.12 |
Where Virginia sits
The same service costs 2.2 times more in Wyoming 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· 44th of 51
$1.12
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.