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 $0.55 Median $1.23 Typical High $1.58 | Facility | None | $0.55 | $1.23 | $1.58 |
Aetna Setting Professional Modifier None Typical Low $0.55 Median $1.23 Typical High $1.58 | Professional | None | $0.55 | $1.23 | $1.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.02 Median $1.23 Typical High $1.23 | Professional | None | $1.02 | $1.23 | $1.23 |
CareFirst Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | None | $1.29 | $1.29 | $1.29 |
Cigna Setting Facility Modifier None Typical Low $1.78 Median $2.29 Typical High $3.16 | Facility | None | $1.78 | $2.29 | $3.16 |
Cigna Setting Professional Modifier None Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | None | $1.20 | $1.20 | $1.20 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.02 Median $1.29 Typical High $4.27 | Professional | None | $1.02 | $1.29 | $4.27 |
Medcost Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | None | $12.30 | $12.30 | $12.30 |
Medcost Setting Facility Modifier None Typical Low $1.62 Median $3.09 Typical High $3.09 | Facility | None | $1.62 | $3.09 | $3.09 |
Sentara Setting Facility Modifier None Typical Low $1.26 Median $3.16 Typical High $3.39 | Facility | None | $1.26 | $3.16 | $3.39 |
Sentara Setting Professional Modifier None Typical Low $1.26 Median $3.16 Typical High $3.39 | Professional | None | $1.26 | $3.16 | $3.39 |
United Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.35 | Professional | None | $1.29 | $1.29 | $1.35 |
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 $0.62 Median $0.62 Typical High $0.65 | Professional | 52 · Reduced service | $0.62 | $0.62 | $0.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.24 Median $0.25 Typical High $0.26 | Professional | 53 · Discontinued | $0.24 | $0.25 | $0.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.18 Median $0.18 Typical High $0.19 | Professional | 55 · Aftercare only | $0.18 | $0.18 | $0.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.12 Median $0.12 Typical High $0.13 | Professional | 56 · Pre-op care only | $0.12 | $0.12 | $0.13 |
Where Virginia sits
The same service costs 3.4 times more in Texas 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· 34th of 51
$1.29
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.