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 $2.88 Median $3.72 Typical High $10.96 | Facility | None | $2.88 | $3.72 | $10.96 |
Aetna Setting Professional Modifier None Typical Low $2.88 Median $3.02 Typical High $4.37 | Professional | None | $2.88 | $3.02 | $4.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | None | $2.88 | $2.88 | $2.88 |
CareFirst Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | None | $3.24 | $3.24 | $3.24 |
Cigna Setting Facility Modifier None Typical Low $4.17 Median $5.89 Typical High $7.41 | Facility | None | $4.17 | $5.89 | $7.41 |
Cigna Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | None | $2.88 | $2.88 | $2.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.45 Median $2.88 Typical High $10.47 | Professional | None | $2.45 | $2.88 | $10.47 |
Medcost Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Medcost Setting Facility Modifier None Typical Low $8.91 Median $10.23 Typical High $10.23 | Facility | None | $8.91 | $10.23 | $10.23 |
Medcost Setting Professional Modifier None Typical Low $9.77 Median $10.23 Typical High $12.02 | Professional | None | $9.77 | $10.23 | $12.02 |
Sentara Setting Facility Modifier None Typical Low $2.95 Median $10.72 Typical High $11.22 | Facility | None | $2.95 | $10.72 | $11.22 |
Sentara Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $11.22 | Professional | None | $2.88 | $2.88 | $11.22 |
United Setting Professional Modifier None Typical Low $3.24 Median $3.47 Typical High $3.63 | Professional | None | $3.24 | $3.47 | $3.63 |
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 $1.45 Median $1.45 Typical High $1.51 | Professional | 52 · Reduced service | $1.45 | $1.45 | $1.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.58 Median $0.58 Typical High $0.62 | Professional | 53 · Discontinued | $0.58 | $0.58 | $0.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.43 Median $0.43 Typical High $0.45 | Professional | 55 · Aftercare only | $0.43 | $0.43 | $0.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $0.30 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $0.30 |
Where Virginia sits
The same service costs 3.1 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· 36th of 51
$2.88
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.