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 $3.02 Median $3.02 Typical High $3.16 | Facility | None | $3.02 | $3.02 | $3.16 |
Aetna Setting Professional Modifier None Typical Low $3.02 Median $3.16 Typical High $3.24 | Professional | None | $3.02 | $3.16 | $3.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.24 Median $6.46 Typical High $10.00 | Facility | None | $3.24 | $6.46 | $10.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.57 Median $3.02 Typical High $3.02 | Professional | None | $2.57 | $3.02 | $3.02 |
CareFirst Setting Professional Modifier None Typical Low $3.31 Median $5.13 Typical High $5.13 | Professional | None | $3.31 | $5.13 | $5.13 |
Cigna Setting Facility Modifier None Typical Low $4.47 Median $5.75 Typical High $7.94 | Facility | None | $4.47 | $5.75 | $7.94 |
Cigna Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | None | $3.02 | $3.02 | $3.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.57 Median $3.16 Typical High $21.88 | Professional | None | $2.57 | $3.16 | $21.88 |
Medcost Setting Facility Modifier None Typical Low $3.24 Median $3.24 Typical High $4.90 | Facility | None | $3.24 | $3.24 | $4.90 |
Sentara Setting Facility Modifier None Typical Low $3.09 Median $17.78 Typical High $19.05 | Facility | None | $3.09 | $17.78 | $19.05 |
Sentara Setting Professional Modifier None Typical Low $3.09 Median $17.78 Typical High $19.05 | Professional | None | $3.09 | $17.78 | $19.05 |
United Setting Facility Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Facility | None | $3.02 | $3.02 | $3.02 |
United Setting Professional Modifier None Typical Low $3.16 Median $3.24 Typical High $3.47 | Professional | None | $3.16 | $3.24 | $3.47 |
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 $1.51 Median $1.55 Typical High $1.58 | Professional | 52 · Reduced service | $1.51 | $1.55 | $1.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.62 Median $0.62 Typical High $0.65 | Professional | 53 · Discontinued | $0.62 | $0.62 | $0.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.46 Median $0.46 Typical High $0.48 | Professional | 55 · Aftercare only | $0.46 | $0.46 | $0.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.31 Typical High $0.32 | Professional | 56 · Pre-op care only | $0.30 | $0.31 | $0.32 |
Where Virginia sits
The same service costs 6.0 times more in Wyoming than in Georgia. 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· 40th of 51
$3.24
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.