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 $0.65 Median $1.05 Typical High $1.62 | Facility | None | $0.65 | $1.05 | $1.62 |
Aetna Setting Professional Modifier None Typical Low $0.65 Median $0.66 Typical High $1.20 | Professional | None | $0.65 | $0.66 | $1.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.54 Median $0.65 Typical High $0.65 | Professional | None | $0.54 | $0.65 | $0.65 |
CareFirst Setting Professional Modifier None Typical Low $0.68 Median $0.83 Typical High $0.83 | Professional | None | $0.68 | $0.83 | $0.83 |
Cigna Setting Facility Modifier None Typical Low $0.93 Median $1.20 Typical High $1.66 | Facility | None | $0.93 | $1.20 | $1.66 |
Cigna Setting Professional Modifier None Typical Low $0.65 Median $0.65 Typical High $0.65 | Professional | None | $0.65 | $0.65 | $0.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.54 Median $0.68 Typical High $0.98 | Professional | None | $0.54 | $0.68 | $0.98 |
Medcost Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | None | $0.79 | $0.79 | $0.79 |
Medcost Setting Facility Modifier None Typical Low $0.62 Median $0.62 Typical High $1.82 | Facility | None | $0.62 | $0.62 | $1.82 |
Sentara Setting Facility Modifier None Typical Low $0.49 Median $0.58 Typical High $0.83 | Facility | None | $0.49 | $0.58 | $0.83 |
Sentara Setting Professional Modifier None Typical Low $0.49 Median $0.58 Typical High $0.83 | Professional | None | $0.49 | $0.58 | $0.83 |
United Setting Professional Modifier None Typical Low $0.66 Median $0.68 Typical High $0.68 | Professional | None | $0.66 | $0.68 | $0.68 |
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 52 · Reduced service Typical Low $0.32 Median $0.32 Typical High $0.34 | Professional | 52 · Reduced service | $0.32 | $0.32 | $0.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.07 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.07 |
Where Virginia sits
The same service costs 2.6 times more in Texas than in Wyoming. 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· 50th of 51
$0.65
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.