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 $0.58 Median $0.58 Typical High $0.62 | Facility | None | $0.58 | $0.58 | $0.62 |
Aetna Setting Professional Modifier None Typical Low $0.58 Median $0.62 Typical High $0.68 | Professional | None | $0.58 | $0.62 | $0.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.68 Median $1.23 Typical High $1.91 | Facility | None | $0.68 | $1.23 | $1.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.49 Median $0.58 Typical High $0.58 | Professional | None | $0.49 | $0.58 | $0.58 |
CareFirst Setting Professional Modifier None Typical Low $0.62 Median $0.62 Typical High $0.68 | Professional | None | $0.62 | $0.62 | $0.68 |
Cigna Setting Facility Modifier None Typical Low $0.85 Median $1.10 Typical High $1.51 | Facility | None | $0.85 | $1.10 | $1.51 |
Cigna Setting Professional Modifier None Typical Low $0.58 Median $0.58 Typical High $0.58 | Professional | None | $0.58 | $0.58 | $0.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.50 Median $0.62 Typical High $2.75 | Professional | None | $0.50 | $0.62 | $2.75 |
Medcost Setting Facility Modifier None Typical Low $0.68 Median $0.68 Typical High $0.93 | Facility | None | $0.68 | $0.68 | $0.93 |
Sentara Setting Facility Modifier None Typical Low $0.60 Median $2.29 Typical High $2.45 | Facility | None | $0.60 | $2.29 | $2.45 |
Sentara Setting Professional Modifier None Typical Low $0.60 Median $2.29 Typical High $2.45 | Professional | None | $0.60 | $2.29 | $2.45 |
United Setting Facility Modifier None Typical Low $0.58 Median $0.58 Typical High $0.58 | Facility | None | $0.58 | $0.58 | $0.58 |
United Setting Professional Modifier None Typical Low $0.68 Median $0.68 Typical High $0.71 | Professional | None | $0.68 | $0.68 | $0.71 |
2 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 $0.28 Median $0.30 Typical High $0.31 | Professional | 52 · Reduced service | $0.28 | $0.30 | $0.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $0.44 Median $0.44 Typical High $0.46 | Professional | 54 · Surgery only | $0.44 | $0.44 | $0.46 |
Where Virginia sits
The same service costs 4.1 times more in Wyoming than in Delaware. 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· 32nd of 51
$0.68
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.