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 $2.69 Median $3.72 Typical High $11.48 | Facility | None | $2.69 | $3.72 | $11.48 |
Aetna Setting Professional Modifier None Typical Low $3.55 Median $3.63 Typical High $3.72 | Professional | None | $3.55 | $3.63 | $3.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.55 Median $7.76 Typical High $12.02 | Facility | None | $3.55 | $7.76 | $12.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.02 Median $3.55 Typical High $3.55 | Professional | None | $3.02 | $3.55 | $3.55 |
CareFirst Setting Professional Modifier None Typical Low $3.39 Median $3.63 Typical High $3.63 | Professional | None | $3.39 | $3.63 | $3.63 |
Cigna Setting Facility Modifier None Typical Low $5.25 Median $6.76 Typical High $9.33 | Facility | None | $5.25 | $6.76 | $9.33 |
Cigna Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.02 Median $3.72 Typical High $11.48 | Professional | None | $3.02 | $3.72 | $11.48 |
Medcost Setting Professional Modifier None Typical Low $4.57 Median $4.57 Typical High $4.57 | Professional | None | $4.57 | $4.57 | $4.57 |
Medcost Setting Facility Modifier None Typical Low $10.00 Median $10.00 Typical High $21.88 | Facility | None | $10.00 | $10.00 | $21.88 |
Sentara Setting Facility Modifier None Typical Low $3.63 Median $8.51 Typical High $9.12 | Facility | None | $3.63 | $8.51 | $9.12 |
Sentara Setting Professional Modifier None Typical Low $3.63 Median $8.51 Typical High $9.12 | Professional | None | $3.63 | $8.51 | $9.12 |
United Setting Professional Modifier None Typical Low $3.31 Median $3.39 Typical High $3.55 | Professional | None | $3.31 | $3.39 | $3.55 |
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 $1.78 Median $1.82 Typical High $1.86 | Professional | 52 · Reduced service | $1.78 | $1.82 | $1.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.71 Median $0.72 Typical High $0.76 | Professional | 53 · Discontinued | $0.71 | $0.72 | $0.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.54 Typical High $0.56 | Professional | 55 · Aftercare only | $0.52 | $0.54 | $0.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.36 Median $0.36 Typical High $0.37 | Professional | 56 · Pre-op care only | $0.36 | $0.36 | $0.37 |
Where Virginia sits
The same service costs 4.0 times more in Oklahoma than in Maryland. 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· 43rd of 51
$3.55
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.