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 $0.38 Median $0.38 Typical High $0.39 | Facility | None | $0.38 | $0.38 | $0.39 |
Aetna Setting Professional Modifier None Typical Low $0.37 Median $0.38 Typical High $0.39 | Professional | None | $0.37 | $0.38 | $0.39 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.76 Median $0.76 Typical High $0.79 | Facility | None | $0.76 | $0.76 | $0.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.59 Median $0.59 Typical High $0.62 | Professional | None | $0.59 | $0.59 | $0.62 |
CareFirst Setting Professional Modifier None Typical Low $0.44 Median $0.44 Typical High $0.52 | Professional | None | $0.44 | $0.44 | $0.52 |
Cigna Setting Facility Modifier None Typical Low $0.28 Median $0.42 Typical High $0.42 | Facility | None | $0.28 | $0.42 | $0.42 |
Cigna Setting Professional Modifier None Typical Low $0.36 Median $0.36 Typical High $0.42 | Professional | None | $0.36 | $0.36 | $0.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.52 Median $0.76 Typical High $0.98 | Professional | None | $0.52 | $0.76 | $0.98 |
Medcost Setting Professional Modifier None Typical Low $0.37 Median $0.49 Typical High $0.69 | Professional | None | $0.37 | $0.49 | $0.69 |
Medcost Setting Facility Modifier None Typical Low $0.24 Median $0.40 Typical High $0.48 | Facility | None | $0.24 | $0.40 | $0.48 |
Medcost Setting Professional Modifier None Typical Low $0.40 Median $0.45 Typical High $0.52 | Professional | None | $0.40 | $0.45 | $0.52 |
Sentara Setting Facility Modifier None Typical Low $0.36 Median $0.55 Typical High $2.14 | Facility | None | $0.36 | $0.55 | $2.14 |
Sentara Setting Professional Modifier None Typical Low $0.38 Median $0.56 Typical High $1.23 | Professional | None | $0.38 | $0.56 | $1.23 |
United Setting Facility Modifier None Typical Low $0.91 Median $0.91 Typical High $1.10 | Facility | None | $0.91 | $0.91 | $1.10 |
United Setting Professional Modifier None Typical Low $0.34 Median $0.37 Typical High $0.55 | Professional | None | $0.34 | $0.37 | $0.55 |
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 $0.19 Median $0.19 Typical High $0.20 | Professional | 52 · Reduced service | $0.19 | $0.19 | $0.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.07 Median $0.08 Typical High $0.08 | Professional | 53 · Discontinued | $0.07 | $0.08 | $0.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 55 · Aftercare only | $0.06 | $0.06 | $0.06 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.04 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | RR · Rental | $0.06 | $0.06 | $0.06 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.44 Median $0.46 Typical High $0.46 | Professional | UE · Used equipment | $0.44 | $0.46 | $0.46 |
Where Virginia sits
The same service costs 2.3 times more in Montana than in Hawaii. 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· 21st of 51
$0.56
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.