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 $0.54 Median $1.38 Typical High $2.09 | Facility | None | $0.54 | $1.38 | $2.09 |
Aetna Setting Professional Modifier None Typical Low $0.62 Median $1.38 Typical High $1.78 | Professional | None | $0.62 | $1.38 | $1.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.17 Median $1.38 Typical High $1.38 | Professional | None | $1.17 | $1.38 | $1.38 |
CareFirst Setting Professional Modifier None Typical Low $0.91 Median $0.91 Typical High $1.17 | Professional | None | $0.91 | $0.91 | $1.17 |
Cigna Setting Facility Modifier None Typical Low $2.00 Median $2.63 Typical High $3.63 | Facility | None | $2.00 | $2.63 | $3.63 |
Cigna Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $1.38 | Professional | None | $1.38 | $1.38 | $1.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.17 Median $1.45 Typical High $2.51 | Professional | None | $1.17 | $1.45 | $2.51 |
Medcost Setting Professional Modifier None Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | None | $1.20 | $1.20 | $1.20 |
Medcost Setting Facility Modifier None Typical Low $1.15 Median $1.15 Typical High $1.58 | Facility | None | $1.15 | $1.15 | $1.58 |
Sentara Setting Facility Modifier None Typical Low $1.41 Median $3.47 Typical High $3.72 | Facility | None | $1.41 | $3.47 | $3.72 |
Sentara Setting Professional Modifier None Typical Low $1.41 Median $3.47 Typical High $3.72 | Professional | None | $1.41 | $3.47 | $3.72 |
United Setting Professional Modifier None Typical Low $1.12 Median $1.15 Typical High $1.23 | Professional | None | $1.12 | $1.15 | $1.23 |
3 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 $0.71 Median $0.71 Typical High $0.72 | Professional | 52 · Reduced service | $0.71 | $0.71 | $0.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.21 Median $0.21 Typical High $0.22 | Professional | 55 · Aftercare only | $0.21 | $0.21 | $0.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.14 Typical High $0.15 | Professional | 56 · Pre-op care only | $0.14 | $0.14 | $0.15 |
Where Virginia sits
The same service costs 5.9 times more in Vermont than in Oklahoma. 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· 41st of 51
$1.38
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.