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 $1.58 Median $1.58 Typical High $1.66 | Facility | None | $1.58 | $1.58 | $1.66 |
Aetna Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $1.66 | Professional | None | $1.58 | $1.58 | $1.66 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.58 Median $3.24 Typical High $5.13 | Facility | None | $1.58 | $3.24 | $5.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.35 Median $1.58 Typical High $1.58 | Professional | None | $1.35 | $1.58 | $1.58 |
CareFirst Setting Professional Modifier None Typical Low $1.45 Median $1.45 Typical High $1.58 | Professional | None | $1.45 | $1.45 | $1.58 |
Cigna Setting Facility Modifier None Typical Low $2.29 Median $2.95 Typical High $4.07 | Facility | None | $2.29 | $2.95 | $4.07 |
Cigna Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $1.58 | Professional | None | $1.58 | $1.58 | $1.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.35 Median $1.66 Typical High $2.40 | Professional | None | $1.35 | $1.66 | $2.40 |
Medcost Setting Professional Modifier None Typical Low $1.91 Median $1.91 Typical High $1.91 | Professional | None | $1.91 | $1.91 | $1.91 |
Medcost Setting Facility Modifier None Typical Low $1.41 Median $1.41 Typical High $2.24 | Facility | None | $1.41 | $1.41 | $2.24 |
Sentara Setting Facility Modifier None Typical Low $1.62 Median $1.91 Typical High $2.24 | Facility | None | $1.62 | $1.91 | $2.24 |
Sentara Setting Professional Modifier None Typical Low $1.62 Median $1.91 Typical High $2.24 | Professional | None | $1.62 | $1.91 | $2.24 |
United Setting Facility Modifier None Typical Low $1.58 Median $1.58 Typical High $1.58 | Facility | None | $1.58 | $1.58 | $1.58 |
United Setting Professional Modifier None Typical Low $1.51 Median $1.58 Typical High $1.66 | Professional | None | $1.51 | $1.58 | $1.66 |
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 $0.79 Median $0.79 Typical High $0.83 | Professional | 52 · Reduced service | $0.79 | $0.79 | $0.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.32 Median $0.32 Typical High $0.33 | Professional | 53 · Discontinued | $0.32 | $0.32 | $0.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.24 Median $0.24 Typical High $0.25 | Professional | 55 · Aftercare only | $0.24 | $0.24 | $0.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.16 Median $0.16 Typical High $0.17 | Professional | 56 · Pre-op care only | $0.16 | $0.16 | $0.17 |
Where Virginia sits
The same service costs 1.7 times more in Arizona than in Alabama. 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
$1.58
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.