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 $4.27 Median $4.27 Typical High $4.27 | Facility | None | $4.27 | $4.27 | $4.27 |
Aetna Setting Professional Modifier None Typical Low $4.17 Median $4.27 Typical High $4.27 | Professional | None | $4.17 | $4.27 | $4.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $8.71 | Facility | None | $8.13 | $8.13 | $8.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $5.50 | Professional | None | $4.90 | $4.90 | $5.50 |
CareFirst Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $5.62 | Professional | None | $4.47 | $4.47 | $5.62 |
Cigna Setting Facility Modifier None Typical Low $4.27 Median $5.13 Typical High $5.13 | Facility | None | $4.27 | $5.13 | $5.13 |
Cigna Setting Professional Modifier None Typical Low $3.80 Median $3.80 Typical High $5.13 | Professional | None | $3.80 | $3.80 | $5.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5.75 Median $8.13 Typical High $10.72 | Professional | None | $5.75 | $8.13 | $10.72 |
Medcost Setting Professional Modifier None Typical Low $4.79 Median $5.37 Typical High $7.41 | Professional | None | $4.79 | $5.37 | $7.41 |
Medcost Setting Facility Modifier None Typical Low $2.82 Median $4.37 Typical High $5.37 | Facility | None | $2.82 | $4.37 | $5.37 |
Medcost Setting Professional Modifier None Typical Low $3.55 Median $4.37 Typical High $5.37 | Professional | None | $3.55 | $4.37 | $5.37 |
Sentara Setting Facility Modifier None Typical Low $3.89 Median $5.62 Typical High $17.38 | Facility | None | $3.89 | $5.62 | $17.38 |
Sentara Setting Professional Modifier None Typical Low $4.37 Median $6.03 Typical High $12.30 | Professional | None | $4.37 | $6.03 | $12.30 |
United Setting Facility Modifier None Typical Low $4.79 Median $5.37 Typical High $10.96 | Facility | None | $4.79 | $5.37 | $10.96 |
United Setting Professional Modifier None Typical Low $3.72 Median $3.98 Typical High $6.17 | Professional | None | $3.72 | $3.98 | $6.17 |
6 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 $2.09 Median $2.09 Typical High $2.14 | Professional | 52 · Reduced service | $2.09 | $2.09 | $2.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.83 Median $0.83 Typical High $0.85 | Professional | 53 · Discontinued | $0.83 | $0.83 | $0.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.63 Median $0.63 Typical High $0.65 | Professional | 55 · Aftercare only | $0.63 | $0.63 | $0.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.42 Median $0.42 Typical High $0.43 | Professional | 56 · Pre-op care only | $0.42 | $0.42 | $0.43 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.50 Median $0.50 Typical High $0.62 | Professional | RR · Rental | $0.50 | $0.50 | $0.62 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.63 Median $3.72 Typical High $3.98 | Professional | UE · Used equipment | $3.63 | $3.72 | $3.98 |
Where Virginia sits
The same service costs 3.2 times more in Hawaii 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· 41st of 51
$4.90
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.