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 $2.09 Median $2.09 Typical High $2.19 | Facility | None | $2.09 | $2.09 | $2.19 |
Aetna Setting Professional Modifier None Typical Low $2.09 Median $2.09 Typical High $2.19 | Professional | None | $2.09 | $2.09 | $2.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.95 Median $4.27 Typical High $6.76 | Facility | None | $1.95 | $4.27 | $6.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.78 Median $2.09 Typical High $2.09 | Professional | None | $1.78 | $2.09 | $2.09 |
CareFirst Setting Professional Modifier None Typical Low $1.82 Median $1.82 Typical High $1.95 | Professional | None | $1.82 | $1.82 | $1.95 |
Cigna Setting Facility Modifier None Typical Low $3.02 Median $3.89 Typical High $5.37 | Facility | None | $3.02 | $3.89 | $5.37 |
Cigna Setting Professional Modifier None Typical Low $2.09 Median $2.09 Typical High $2.09 | Professional | None | $2.09 | $2.09 | $2.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.78 Median $2.19 Typical High $2.51 | Professional | None | $1.78 | $2.19 | $2.51 |
Medcost Setting Facility Modifier None Typical Low $1.95 Median $1.95 Typical High $2.69 | Facility | None | $1.95 | $1.95 | $2.69 |
Sentara Setting Facility Modifier None Typical Low $1.91 Median $2.09 Typical High $2.69 | Facility | None | $1.91 | $2.09 | $2.69 |
Sentara Setting Professional Modifier None Typical Low $1.91 Median $2.09 Typical High $2.69 | Professional | None | $1.91 | $2.09 | $2.69 |
United Setting Facility Modifier None Typical Low $2.09 Median $2.09 Typical High $2.09 | Facility | None | $2.09 | $2.09 | $2.09 |
United Setting Professional Modifier None Typical Low $1.91 Median $1.95 Typical High $2.04 | Professional | None | $1.91 | $1.95 | $2.04 |
5 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 $1.05 Median $1.05 Typical High $1.10 | Professional | 52 · Reduced service | $1.05 | $1.05 | $1.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.42 Median $0.42 Typical High $0.44 | Professional | 53 · Discontinued | $0.42 | $0.42 | $0.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1.55 Median $1.58 Typical High $1.62 | Professional | 54 · Surgery only | $1.55 | $1.58 | $1.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.31 Median $0.32 Typical High $0.33 | Professional | 55 · Aftercare only | $0.31 | $0.32 | $0.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.21 Median $0.21 Typical High $0.22 | Professional | 56 · Pre-op care only | $0.21 | $0.21 | $0.22 |
Where Virginia sits
The same service costs 117.5 times more in Alabama 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· 43rd of 51
$2.09
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.