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 $0.71 Median $1.95 Typical High $2.04 | Facility | None | $0.71 | $1.95 | $2.04 |
Aetna Setting Professional Modifier None Typical Low $1.00 Median $2.04 Typical High $2.04 | Professional | None | $1.00 | $2.04 | $2.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $1.95 | Professional | None | $1.95 | $1.95 | $1.95 |
CareFirst Setting Professional Modifier None Typical Low $1.62 Median $1.91 Typical High $1.91 | Professional | None | $1.62 | $1.91 | $1.91 |
Cigna Setting Facility Modifier None Typical Low $2.82 Median $3.63 Typical High $5.01 | Facility | None | $2.82 | $3.63 | $5.01 |
Cigna Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $1.95 | Professional | None | $1.95 | $1.95 | $1.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.98 Median $1.66 Typical High $2.04 | Professional | None | $0.98 | $1.66 | $2.04 |
Medcost Setting Professional Modifier None Typical Low $0.42 Median $0.42 Typical High $0.42 | Professional | None | $0.42 | $0.42 | $0.42 |
Medcost Setting Facility Modifier None Typical Low $1.10 Median $1.10 Typical High $1.20 | Facility | None | $1.10 | $1.10 | $1.20 |
Medcost Setting Professional Modifier None Typical Low $0.46 Median $1.91 Typical High $2.04 | Professional | None | $0.46 | $1.91 | $2.04 |
Sentara Setting Facility Modifier None Typical Low $0.87 Median $1.05 Typical High $2.51 | Facility | None | $0.87 | $1.05 | $2.51 |
Sentara Setting Professional Modifier None Typical Low $0.98 Median $1.95 Typical High $1.95 | Professional | None | $0.98 | $1.95 | $1.95 |
United Setting Professional Modifier None Typical Low $0.65 Median $0.91 Typical High $0.95 | Professional | None | $0.65 | $0.91 | $0.95 |
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 55 · Aftercare only Typical Low $0.15 Median $0.31 Typical High $0.31 | Professional | 55 · Aftercare only | $0.15 | $0.31 | $0.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.20 Typical High $0.20 | Professional | 56 · Pre-op care only | $0.10 | $0.20 | $0.20 |
Where Virginia sits
The same service costs 2.3 times more in Arkansas than in North Carolina. 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· 16th of 51
$1.95
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.