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 $0.83 Median $0.83 Typical High $0.87 | Facility | None | $0.83 | $0.83 | $0.87 |
Aetna Setting Professional Modifier None Typical Low $0.83 Median $0.87 Typical High $0.89 | Professional | None | $0.83 | $0.87 | $0.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.58 Median $0.58 Typical High $1.00 | Professional | None | $0.58 | $0.58 | $1.00 |
Cigna Setting Professional Modifier None Typical Low $0.47 Median $0.85 Typical High $0.85 | Professional | None | $0.47 | $0.85 | $0.85 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.00 Median $1.41 Typical High $1.48 | Professional | None | $1.00 | $1.41 | $1.48 |
Medcost Setting Facility Modifier None Typical Low $0.83 Median $1.15 Typical High $1.86 | Facility | None | $0.83 | $1.15 | $1.86 |
Sentara Setting Facility Modifier None Typical Low $0.83 Median $1.15 Typical High $10,232.93 | Facility | None | $0.83 | $1.15 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $0.83 Median $1.15 Typical High $10,232.93 | Professional | None | $0.83 | $1.15 | $10,232.93 |
United Setting Professional Modifier None Typical Low $0.85 Median $1.38 Typical High $1.82 | Professional | None | $0.85 | $1.38 | $1.82 |
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 $0.42 Median $0.44 Typical High $0.44 | Professional | 52 · Reduced service | $0.42 | $0.44 | $0.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.17 Median $0.18 Typical High $0.18 | Professional | 53 · Discontinued | $0.17 | $0.18 | $0.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.12 Median $0.13 Typical High $0.13 | Professional | 55 · Aftercare only | $0.12 | $0.13 | $0.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.09 Typical High $0.09 | Professional | 56 · Pre-op care only | $0.08 | $0.09 | $0.09 |
Where Virginia sits
The same service costs 104.7 times more in Wyoming than in Connecticut. 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· 29th of 51
$1.05
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.