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 $5.62 Median $6.17 Typical High $19.05 | Facility | None | $5.62 | $6.17 | $19.05 |
Aetna Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $5.89 | Professional | None | $5.62 | $5.62 | $5.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.79 Median $5.62 Typical High $5.62 | Professional | None | $4.79 | $5.62 | $5.62 |
CareFirst Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $5.89 | Professional | None | $2.95 | $2.95 | $5.89 |
Cigna Setting Facility Modifier None Typical Low $8.13 Median $10.47 Typical High $14.45 | Facility | None | $8.13 | $10.47 | $14.45 |
Cigna Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | None | $5.62 | $5.62 | $5.62 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.79 Median $5.89 Typical High $28.84 | Professional | None | $4.79 | $5.89 | $28.84 |
Medcost Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | None | $27.54 | $27.54 | $27.54 |
Medcost Setting Facility Modifier None Typical Low $16.98 Median $16.98 Typical High $31.62 | Facility | None | $16.98 | $16.98 | $31.62 |
Sentara Setting Facility Modifier None Typical Low $5.75 Median $17.38 Typical High $18.62 | Facility | None | $5.75 | $17.38 | $18.62 |
Sentara Setting Professional Modifier None Typical Low $5.75 Median $17.38 Typical High $18.62 | Professional | None | $5.75 | $17.38 | $18.62 |
United Setting Professional Modifier None Typical Low $5.75 Median $5.89 Typical High $6.17 | Professional | None | $5.75 | $5.89 | $6.17 |
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 $2.82 Median $2.82 Typical High $2.95 | Professional | 52 · Reduced service | $2.82 | $2.82 | $2.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.12 Median $1.12 Typical High $1.17 | Professional | 53 · Discontinued | $1.12 | $1.12 | $1.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.83 Median $0.85 Typical High $0.87 | Professional | 55 · Aftercare only | $0.83 | $0.85 | $0.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.56 Median $0.56 Typical High $0.59 | Professional | 56 · Pre-op care only | $0.56 | $0.56 | $0.59 |
Where Virginia sits
The same service costs 3.2 times more in Oklahoma than in North Dakota. 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· 48th of 51
$5.75
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.