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 $1.00 Median $1.70 Typical High $2.88 | Facility | None | $1.00 | $1.70 | $2.88 |
Aetna Setting Professional Modifier None Typical Low $1.00 Median $1.29 Typical High $2.88 | Professional | None | $1.00 | $1.29 | $2.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.85 Median $1.00 Typical High $1.00 | Professional | None | $0.85 | $1.00 | $1.00 |
CareFirst Setting Professional Modifier None Typical Low $0.81 Median $0.81 Typical High $0.89 | Professional | None | $0.81 | $0.81 | $0.89 |
Cigna Setting Facility Modifier None Typical Low $1.45 Median $1.86 Typical High $2.57 | Facility | None | $1.45 | $1.86 | $2.57 |
Cigna Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | None | $1.00 | $1.00 | $1.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.85 Median $1.05 Typical High $3.80 | Professional | None | $0.85 | $1.05 | $3.80 |
Medcost Setting Professional Modifier None Typical Low $2.09 Median $2.09 Typical High $2.09 | Professional | None | $2.09 | $2.09 | $2.09 |
Medcost Setting Facility Modifier None Typical Low $1.86 Median $1.86 Typical High $2.82 | Facility | None | $1.86 | $1.86 | $2.82 |
Sentara Setting Facility Modifier None Typical Low $1.02 Median $1.91 Typical High $2.04 | Facility | None | $1.02 | $1.91 | $2.04 |
Sentara Setting Professional Modifier None Typical Low $1.02 Median $1.91 Typical High $2.04 | Professional | None | $1.02 | $1.91 | $2.04 |
United Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $0.95 | Professional | None | $0.89 | $0.89 | $0.95 |
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 $0.50 Median $0.51 Typical High $0.52 | Professional | 52 · Reduced service | $0.50 | $0.51 | $0.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.20 Median $0.20 Typical High $0.21 | Professional | 53 · Discontinued | $0.20 | $0.20 | $0.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.15 Median $0.15 Typical High $0.16 | Professional | 55 · Aftercare only | $0.15 | $0.15 | $0.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.10 Typical High $0.11 | Professional | 56 · Pre-op care only | $0.10 | $0.10 | $0.11 |
Where Virginia sits
The same service costs 2.5 times more in Texas 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· 29th of 51
$1.05
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.