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 $3.72 Median $3.72 Typical High $3.89 | Facility | None | $3.72 | $3.72 | $3.89 |
Aetna Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $3.89 | Professional | None | $3.72 | $3.72 | $3.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.55 Median $7.59 Typical High $12.02 | Facility | None | $3.55 | $7.59 | $12.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.16 Median $3.72 Typical High $3.72 | Professional | None | $3.16 | $3.72 | $3.72 |
CareFirst Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.55 | Professional | None | $3.39 | $3.39 | $3.55 |
Cigna Setting Facility Modifier None Typical Low $5.37 Median $7.08 Typical High $9.55 | Facility | None | $5.37 | $7.08 | $9.55 |
Cigna Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | None | $3.72 | $3.72 | $3.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.16 Median $3.89 Typical High $4.79 | Professional | None | $3.16 | $3.89 | $4.79 |
Medcost Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $5.62 | Facility | None | $3.55 | $3.55 | $5.62 |
Sentara Setting Facility Modifier None Typical Low $3.80 Median $4.37 Typical High $4.90 | Facility | None | $3.80 | $4.37 | $4.90 |
Sentara Setting Professional Modifier None Typical Low $3.80 Median $4.37 Typical High $4.90 | Professional | None | $3.80 | $4.37 | $4.90 |
United Setting Facility Modifier None Typical Low $3.72 Median $3.72 Typical High $3.72 | Facility | None | $3.72 | $3.72 | $3.72 |
United Setting Professional Modifier None Typical Low $3.47 Median $3.55 Typical High $3.80 | Professional | None | $3.47 | $3.55 | $3.80 |
3 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 $1.86 Median $1.86 Typical High $1.95 | Professional | 52 · Reduced service | $1.86 | $1.86 | $1.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.74 Median $0.76 Typical High $0.78 | Professional | 53 · Discontinued | $0.74 | $0.76 | $0.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.37 Median $0.38 Typical High $0.39 | Professional | 56 · Pre-op care only | $0.37 | $0.38 | $0.39 |
Where Virginia sits
The same service costs 1.9 times more in Alaska than in Rhode Island. 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· 31st of 51
$3.72
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.