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 $2.95 Median $3.09 Typical High $5.50 | Facility | None | $2.95 | $3.09 | $5.50 |
Aetna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $3.09 | Professional | None | $2.95 | $2.95 | $3.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.95 Median $6.31 Typical High $10.00 | Facility | None | $2.95 | $6.31 | $10.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.45 Median $2.95 Typical High $2.95 | Professional | None | $2.45 | $2.95 | $2.95 |
CareFirst Setting Professional Modifier None Typical Low $3.16 Median $3.24 Typical High $3.24 | Professional | None | $3.16 | $3.24 | $3.24 |
Cigna Setting Facility Modifier None Typical Low $4.27 Median $5.50 Typical High $7.59 | Facility | None | $4.27 | $5.50 | $7.59 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | None | $2.95 | $2.95 | $2.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.45 Median $3.09 Typical High $5.01 | Professional | None | $2.45 | $3.09 | $5.01 |
Medcost Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | None | $15.85 | $15.85 | $15.85 |
Medcost Setting Facility Modifier None Typical Low $2.57 Median $2.57 Typical High $4.68 | Facility | None | $2.57 | $2.57 | $4.68 |
Sentara Setting Facility Modifier None Typical Low $2.04 Median $2.45 Typical High $3.80 | Facility | None | $2.04 | $2.45 | $3.80 |
Sentara Setting Professional Modifier None Typical Low $2.04 Median $2.45 Typical High $3.80 | Professional | None | $2.04 | $2.45 | $3.80 |
United Setting Professional Modifier None Typical Low $3.09 Median $3.16 Typical High $3.39 | Professional | None | $3.09 | $3.16 | $3.39 |
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 55 · Aftercare only Typical Low $0.44 Median $0.44 Typical High $0.46 | Professional | 55 · Aftercare only | $0.44 | $0.44 | $0.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.30 Typical High $0.31 | Professional | 56 · Pre-op care only | $0.28 | $0.30 | $0.31 |
Where Virginia sits
The same service costs 6.0 times more in Oklahoma 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· 49th of 51
$2.95
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.