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 $2.82 Median $3.31 Typical High $5.25 | Facility | None | $2.82 | $3.31 | $5.25 |
Aetna Setting Professional Modifier None Typical Low $2.82 Median $2.95 Typical High $3.02 | Professional | None | $2.82 | $2.95 | $3.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.40 Median $2.82 Typical High $2.82 | Professional | None | $2.40 | $2.82 | $2.82 |
CareFirst Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $3.09 | Professional | None | $2.88 | $2.88 | $3.09 |
Cigna Setting Facility Modifier None Typical Low $4.17 Median $5.37 Typical High $7.41 | Facility | None | $4.17 | $5.37 | $7.41 |
Cigna Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $2.82 | Professional | None | $2.82 | $2.82 | $2.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.40 Median $3.02 Typical High $6.61 | Professional | None | $2.40 | $3.02 | $6.61 |
Medcost Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | None | $14.45 | $14.45 | $14.45 |
Medcost Setting Facility Modifier None Typical Low $5.75 Median $5.75 Typical High $6.46 | Facility | None | $5.75 | $5.75 | $6.46 |
Sentara Setting Facility Modifier None Typical Low $2.95 Median $5.89 Typical High $6.31 | Facility | None | $2.95 | $5.89 | $6.31 |
Sentara Setting Professional Modifier None Typical Low $2.95 Median $5.89 Typical High $6.31 | Professional | None | $2.95 | $5.89 | $6.31 |
United Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $3.24 | Professional | None | $3.09 | $3.09 | $3.24 |
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 $1.45 Median $1.45 Typical High $1.51 | Professional | 52 · Reduced service | $1.45 | $1.45 | $1.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.56 Median $0.58 Typical High $0.60 | Professional | 53 · Discontinued | $0.56 | $0.58 | $0.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.43 Median $0.43 Typical High $0.45 | Professional | 55 · Aftercare only | $0.43 | $0.43 | $0.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $0.30 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $0.30 |
Where Virginia sits
The same service costs 2.0 times more in Wyoming than in Florida. 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· 47th of 51
$3.02
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.