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 $3.72 Median $4.68 Typical High $12.88 | Facility | None | $3.72 | $4.68 | $12.88 |
Aetna Setting Professional Modifier None Typical Low $3.72 Median $4.57 Typical High $4.68 | Professional | None | $3.72 | $4.57 | $4.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.90 Median $4.90 Typical High $23.99 | Facility | None | $4.90 | $4.90 | $23.99 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.45 Median $2.95 Typical High $3.63 | Professional | None | $2.45 | $2.95 | $3.63 |
CareFirst Setting Professional Modifier None Typical Low $3.55 Median $3.98 Typical High $6.17 | Professional | None | $3.55 | $3.98 | $6.17 |
Cigna Setting Facility Modifier None Typical Low $3.24 Median $3.47 Typical High $6.46 | Facility | None | $3.24 | $3.47 | $6.46 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $5.25 | Professional | None | $2.95 | $2.95 | $5.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.90 Median $5.89 Typical High $7.41 | Professional | None | $4.90 | $5.89 | $7.41 |
Medcost Setting Facility Modifier None Typical Low $3.24 Median $4.57 Typical High $8.91 | Facility | None | $3.24 | $4.57 | $8.91 |
Medcost Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | None | $3.98 | $3.98 | $3.98 |
Sentara Setting Facility Modifier None Typical Low $5.89 Median $10,232.93 Typical High $11,481.54 | Facility | None | $5.89 | $10,232.93 | $11,481.54 |
Sentara Setting Professional Modifier None Typical Low $5.89 Median $10,232.93 Typical High $11,481.54 | Professional | None | $5.89 | $10,232.93 | $11,481.54 |
United Setting Facility Modifier None Typical Low $5.89 Median $5.89 Typical High $5.89 | Facility | None | $5.89 | $5.89 | $5.89 |
United Setting Professional Modifier None Typical Low $2.09 Median $2.75 Typical High $4.90 | Professional | None | $2.09 | $2.75 | $4.90 |
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 $1.86 Median $2.29 Typical High $2.34 | Professional | 52 · Reduced service | $1.86 | $2.29 | $2.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.74 Median $0.91 Typical High $0.93 | Professional | 53 · Discontinued | $0.74 | $0.91 | $0.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.56 Median $0.68 Typical High $0.71 | Professional | 55 · Aftercare only | $0.56 | $0.68 | $0.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.37 Median $0.46 Typical High $0.47 | Professional | 56 · Pre-op care only | $0.37 | $0.46 | $0.47 |
Where Virginia sits
The same service costs 3.6 times more in Mississippi 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· 40th of 51
$3.39
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.