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 $2.29 Median $2.40 Typical High $4.27 | Facility | None | $2.29 | $2.40 | $4.27 |
Aetna Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $2.40 | Professional | None | $2.29 | $2.29 | $2.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.95 Median $2.29 Typical High $2.29 | Professional | None | $1.95 | $2.29 | $2.29 |
CareFirst Setting Professional Modifier None Typical Low $2.45 Median $3.24 Typical High $3.24 | Professional | None | $2.45 | $3.24 | $3.24 |
Cigna Setting Facility Modifier None Typical Low $3.31 Median $4.27 Typical High $5.89 | Facility | None | $3.31 | $4.27 | $5.89 |
Cigna Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $2.29 | Professional | None | $2.29 | $2.29 | $2.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.95 Median $2.40 Typical High $16.60 | Professional | None | $1.95 | $2.40 | $16.60 |
Medcost Setting Facility Modifier None Typical Low $2.45 Median $2.45 Typical High $11.22 | Facility | None | $2.45 | $2.45 | $11.22 |
Sentara Setting Facility Modifier None Typical Low $2.34 Median $3.02 Typical High $3.16 | Facility | None | $2.34 | $3.02 | $3.16 |
Sentara Setting Professional Modifier None Typical Low $2.34 Median $3.02 Typical High $3.16 | Professional | None | $2.34 | $3.02 | $3.16 |
United Setting Professional Modifier None Typical Low $2.40 Median $2.45 Typical High $2.57 | Professional | None | $2.40 | $2.45 | $2.57 |
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 $1.12 Median $1.15 Typical High $1.20 | Professional | 52 · Reduced service | $1.12 | $1.15 | $1.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.45 Median $0.46 Typical High $0.48 | Professional | 53 · Discontinued | $0.45 | $0.46 | $0.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.34 Median $0.34 Typical High $0.36 | Professional | 55 · Aftercare only | $0.34 | $0.34 | $0.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.23 Median $0.23 Typical High $0.24 | Professional | 56 · Pre-op care only | $0.23 | $0.23 | $0.24 |
Where Virginia sits
The same service costs 4.8 times more in Oklahoma 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· 47th of 51
$2.40
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.