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 $11.48 Median $11.48 Typical High $12.30 | Facility | None | $11.48 | $11.48 | $12.30 |
Aetna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $12.30 | Professional | None | $11.48 | $11.48 | $12.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $13.80 Median $25.12 Typical High $38.02 | Facility | None | $13.80 | $25.12 | $38.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | None | $11.48 | $11.48 | $11.48 |
CareFirst Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | None | $13.80 | $13.80 | $13.80 |
Cigna Setting Facility Modifier None Typical Low $16.98 Median $23.44 Typical High $30.20 | Facility | None | $16.98 | $23.44 | $30.20 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | None | $11.48 | $11.48 | $11.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $9.77 Median $11.48 Typical High $26.30 | Professional | None | $9.77 | $11.48 | $26.30 |
Medcost Setting Facility Modifier None Typical Low $13.80 Median $13.80 Typical High $43.65 | Facility | None | $13.80 | $13.80 | $43.65 |
Medcost Setting Professional Modifier None Typical Low $13.80 Median $24.55 Typical High $30.90 | Professional | None | $13.80 | $24.55 | $30.90 |
Sentara Setting Facility Modifier None Typical Low $12.02 Median $27.54 Typical High $29.51 | Facility | None | $12.02 | $27.54 | $29.51 |
Sentara Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $29.51 | Professional | None | $11.48 | $11.48 | $29.51 |
United Setting Facility Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Facility | None | $11.48 | $11.48 | $11.48 |
United Setting Professional Modifier None Typical Low $13.80 Median $14.79 Typical High $15.49 | Professional | None | $13.80 | $14.79 | $15.49 |
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 $5.75 Median $5.75 Typical High $6.03 | Professional | 52 · Reduced service | $5.75 | $5.75 | $6.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $2.29 Typical High $2.45 | Professional | 53 · Discontinued | $2.29 | $2.29 | $2.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.74 Median $1.74 Typical High $1.82 | Professional | 55 · Aftercare only | $1.74 | $1.74 | $1.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.15 Median $1.15 Typical High $1.23 | Professional | 56 · Pre-op care only | $1.15 | $1.15 | $1.23 |
Where Virginia sits
The same service costs 1.8 times more in Alaska than in Kentucky. 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· 46th of 51
$11.48
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.