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 $4.27 Median $4.27 Typical High $4.47 | Facility | None | $4.27 | $4.27 | $4.47 |
Aetna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.47 | Professional | None | $4.27 | $4.27 | $4.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.63 Median $4.27 Typical High $4.27 | Professional | None | $3.63 | $4.27 | $4.27 |
CareFirst Setting Professional Modifier None Typical Low $4.68 Median $5.25 Typical High $5.25 | Professional | None | $4.68 | $5.25 | $5.25 |
Cigna Setting Facility Modifier None Typical Low $6.17 Median $7.94 Typical High $10.96 | Facility | None | $6.17 | $7.94 | $10.96 |
Cigna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.63 Median $4.47 Typical High $13.49 | Professional | None | $3.63 | $4.47 | $13.49 |
Medcost Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | None | $4.37 | $4.37 | $4.37 |
Medcost Setting Facility Modifier None Typical Low $4.68 Median $4.68 Typical High $19.95 | Facility | None | $4.68 | $4.68 | $19.95 |
Sentara Setting Facility Modifier None Typical Low $4.37 Median $10.23 Typical High $10.72 | Facility | None | $4.37 | $10.23 | $10.72 |
Sentara Setting Professional Modifier None Typical Low $4.37 Median $10.23 Typical High $10.72 | Professional | None | $4.37 | $10.23 | $10.72 |
United Setting Professional Modifier None Typical Low $4.57 Median $4.68 Typical High $5.01 | Professional | None | $4.57 | $4.68 | $5.01 |
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 $2.14 Median $2.14 Typical High $2.24 | Professional | 52 · Reduced service | $2.14 | $2.14 | $2.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.85 Median $0.85 Typical High $0.89 | Professional | 53 · Discontinued | $0.85 | $0.85 | $0.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.63 Median $0.65 Typical High $0.68 | Professional | 55 · Aftercare only | $0.63 | $0.65 | $0.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.42 Median $0.43 Typical High $0.45 | Professional | 56 · Pre-op care only | $0.42 | $0.43 | $0.45 |
Where Virginia sits
The same service costs 3.4 times more in Texas 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· 46th of 51
$4.47
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.