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 $3.09 Median $3.09 Typical High $3.24 | Facility | None | $3.09 | $3.09 | $3.24 |
Aetna Setting Professional Modifier None Typical Low $3.09 Median $3.24 Typical High $3.31 | Professional | None | $3.09 | $3.24 | $3.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $3.09 | Professional | None | $3.09 | $3.09 | $3.09 |
CareFirst Setting Professional Modifier None Typical Low $3.02 Median $3.16 Typical High $3.16 | Professional | None | $3.02 | $3.16 | $3.16 |
Cigna Setting Facility Modifier None Typical Low $4.47 Median $5.75 Typical High $7.94 | Facility | None | $4.47 | $5.75 | $7.94 |
Cigna Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $3.47 | Professional | None | $3.09 | $3.09 | $3.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.29 Median $3.09 Typical High $4.17 | Professional | None | $2.29 | $3.09 | $4.17 |
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 $4.90 Median $4.90 Typical High $19.50 | Facility | None | $4.90 | $4.90 | $19.50 |
Medcost Setting Professional Modifier None Typical Low $2.00 Median $3.16 Typical High $3.24 | Professional | None | $2.00 | $3.16 | $3.24 |
Sentara Setting Facility Modifier None Typical Low $3.16 Median $5.62 Typical High $5.89 | Facility | None | $3.16 | $5.62 | $5.89 |
Sentara Setting Professional Modifier None Typical Low $3.09 Median $3.16 Typical High $5.89 | Professional | None | $3.09 | $3.16 | $5.89 |
United Setting Professional Modifier None Typical Low $2.04 Median $3.16 Typical High $3.31 | Professional | None | $2.04 | $3.16 | $3.31 |
2 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 55 · Aftercare only Typical Low $0.46 Median $0.48 Typical High $0.49 | Professional | 55 · Aftercare only | $0.46 | $0.48 | $0.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.31 Median $0.32 Typical High $0.33 | Professional | 56 · Pre-op care only | $0.31 | $0.32 | $0.33 |
Where Virginia sits
The same service costs 3.5 times more in Oklahoma than in Virginia. 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· 51st of 51
$3.09
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.