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 $1.45 Median $2.04 Typical High $2.88 | Facility | None | $1.45 | $2.04 | $2.88 |
Aetna Setting Professional Modifier None Typical Low $1.45 Median $2.04 Typical High $2.51 | Professional | None | $1.45 | $2.04 | $2.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.62 Median $1.95 Typical High $1.95 | Professional | None | $1.62 | $1.95 | $1.95 |
CareFirst Setting Professional Modifier None Typical Low $1.95 Median $2.45 Typical High $2.45 | Professional | None | $1.95 | $2.45 | $2.45 |
Cigna Setting Facility Modifier None Typical Low $2.82 Median $3.63 Typical High $5.01 | Facility | None | $2.82 | $3.63 | $5.01 |
Cigna Setting Professional Modifier None Typical Low $1.91 Median $1.91 Typical High $1.91 | Professional | None | $1.91 | $1.91 | $1.91 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.62 Median $2.04 Typical High $7.41 | Professional | None | $1.62 | $2.04 | $7.41 |
Medcost Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | None | $3.02 | $3.02 | $3.02 |
Medcost Setting Facility Modifier None Typical Low $3.31 Median $3.31 Typical High $3.47 | Facility | None | $3.31 | $3.31 | $3.47 |
Sentara Setting Facility Modifier None Typical Low $1.95 Median $3.39 Typical High $3.55 | Facility | None | $1.95 | $3.39 | $3.55 |
Sentara Setting Professional Modifier None Typical Low $1.95 Median $3.39 Typical High $3.55 | Professional | None | $1.95 | $3.39 | $3.55 |
United Setting Professional Modifier None Typical Low $1.86 Median $1.95 Typical High $2.04 | Professional | None | $1.86 | $1.95 | $2.04 |
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 $0.98 Median $0.98 Typical High $1.00 | Professional | 52 · Reduced service | $0.98 | $0.98 | $1.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.39 Median $0.39 Typical High $0.40 | Professional | 53 · Discontinued | $0.39 | $0.39 | $0.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.28 Median $0.28 Typical High $0.30 | Professional | 55 · Aftercare only | $0.28 | $0.28 | $0.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.19 Median $0.19 Typical High $0.20 | Professional | 56 · Pre-op care only | $0.19 | $0.19 | $0.20 |
Where Virginia sits
The same service costs 2.5 times more in Texas than in Tennessee. 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· 36th of 51
$1.95
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.