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 $3.24 Median $3.24 Typical High $3.39 | Facility | None | $3.24 | $3.24 | $3.39 |
Aetna Setting Professional Modifier None Typical Low $3.24 Median $3.31 Typical High $3.39 | Professional | None | $3.24 | $3.31 | $3.39 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.75 Median $3.24 Typical High $3.24 | Professional | None | $2.75 | $3.24 | $3.24 |
CareFirst Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $3.16 | Professional | None | $2.88 | $2.88 | $3.16 |
Cigna Setting Facility Modifier None Typical Low $4.79 Median $6.17 Typical High $8.51 | Facility | None | $4.79 | $6.17 | $8.51 |
Cigna Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | None | $3.24 | $3.24 | $3.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.75 Median $3.39 Typical High $4.07 | Professional | None | $2.75 | $3.39 | $4.07 |
Medcost Setting Facility Modifier None Typical Low $3.16 Median $3.16 Typical High $5.25 | Facility | None | $3.16 | $3.16 | $5.25 |
Sentara Setting Facility Modifier None Typical Low $3.09 Median $3.47 Typical High $4.27 | Facility | None | $3.09 | $3.47 | $4.27 |
Sentara Setting Professional Modifier None Typical Low $3.09 Median $3.47 Typical High $4.27 | Professional | None | $3.09 | $3.47 | $4.27 |
United Setting Professional Modifier None Typical Low $3.09 Median $3.16 Typical High $3.31 | Professional | None | $3.09 | $3.16 | $3.31 |
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 $1.62 Median $1.62 Typical High $1.70 | Professional | 52 · Reduced service | $1.62 | $1.62 | $1.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.65 Median $0.66 Typical High $0.68 | Professional | 53 · Discontinued | $0.65 | $0.66 | $0.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.49 Median $0.49 Typical High $0.51 | Professional | 55 · Aftercare only | $0.49 | $0.49 | $0.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.33 Median $0.33 Typical High $0.34 | Professional | 56 · Pre-op care only | $0.33 | $0.33 | $0.34 |
Where Virginia sits
The same service costs 2.0 times more in Arizona than in Oklahoma. 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· 23rd of 51
$3.24
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.