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 $2.45 Median $2.45 Typical High $2.57 | Facility | None | $2.45 | $2.45 | $2.57 |
Aetna Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $2.57 | Professional | None | $2.45 | $2.45 | $2.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.40 Median $5.01 Typical High $7.94 | Facility | None | $2.40 | $5.01 | $7.94 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.09 Median $2.45 Typical High $2.45 | Professional | None | $2.09 | $2.45 | $2.45 |
CareFirst Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $2.40 | Professional | None | $2.29 | $2.29 | $2.40 |
Cigna Setting Facility Modifier None Typical Low $3.55 Median $4.57 Typical High $6.31 | Facility | None | $3.55 | $4.57 | $6.31 |
Cigna Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | None | $2.45 | $2.45 | $2.45 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.09 Median $2.57 Typical High $3.31 | Professional | None | $2.09 | $2.57 | $3.31 |
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 $2.29 Median $2.29 Typical High $3.39 | Facility | None | $2.29 | $2.29 | $3.39 |
Sentara Setting Facility Modifier None Typical Low $2.45 Median $2.63 Typical High $3.24 | Facility | None | $2.45 | $2.63 | $3.24 |
Sentara Setting Professional Modifier None Typical Low $2.45 Median $2.63 Typical High $3.24 | Professional | None | $2.45 | $2.63 | $3.24 |
United Setting Facility Modifier None Typical Low $2.45 Median $2.45 Typical High $2.45 | Facility | None | $2.45 | $2.45 | $2.45 |
United Setting Professional Modifier None Typical Low $2.34 Median $2.40 Typical High $2.51 | Professional | None | $2.34 | $2.40 | $2.51 |
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 $1.23 Median $1.23 Typical High $1.29 | Professional | 52 · Reduced service | $1.23 | $1.23 | $1.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.49 Median $0.49 Typical High $0.51 | Professional | 53 · Discontinued | $0.49 | $0.49 | $0.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.37 Median $0.37 Typical High $0.39 | Professional | 55 · Aftercare only | $0.37 | $0.37 | $0.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.25 Median $0.25 Typical High $0.26 | Professional | 56 · Pre-op care only | $0.25 | $0.25 | $0.26 |
Where Virginia sits
The same service costs 1.7 times more in Arizona than in Iowa. 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
$2.45
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.