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 $8.32 Median $8.32 Typical High $8.71 | Facility | None | $8.32 | $8.32 | $8.71 |
Aetna Setting Professional Modifier None Typical Low $6.03 Median $8.71 Typical High $8.71 | Professional | None | $6.03 | $8.71 | $8.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.89 Median $7.08 Typical High $7.94 | Professional | None | $5.89 | $7.08 | $7.94 |
Cigna Setting Professional Modifier None Typical Low $4.68 Median $6.46 Typical High $6.46 | Professional | None | $4.68 | $6.46 | $6.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $10.47 Median $15.14 Typical High $15.85 | Professional | None | $10.47 | $15.14 | $15.85 |
Medcost Setting Facility Modifier None Typical Low $6.46 Median $8.71 Typical High $12.88 | Facility | None | $6.46 | $8.71 | $12.88 |
Medcost Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | None | $7.24 | $7.24 | $7.24 |
Sentara Setting Facility Modifier None Typical Low $1.86 Median $5.50 Typical High $10,232.93 | Facility | None | $1.86 | $5.50 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1.86 Median $5.50 Typical High $10,232.93 | Professional | None | $1.86 | $5.50 | $10,232.93 |
United Setting Professional Modifier None Typical Low $8.32 Median $13.80 Typical High $17.38 | Professional | None | $8.32 | $13.80 | $17.38 |
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 $4.17 Median $4.37 Typical High $4.47 | Professional | 52 · Reduced service | $4.17 | $4.37 | $4.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.66 Median $1.74 Typical High $1.78 | Professional | 53 · Discontinued | $1.66 | $1.74 | $1.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.26 Median $1.32 Typical High $1.32 | Professional | 55 · Aftercare only | $1.26 | $1.32 | $1.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.83 Median $0.87 Typical High $0.87 | Professional | 56 · Pre-op care only | $0.83 | $0.87 | $0.87 |
Where Virginia sits
The same service costs 25.1 times more in Wyoming than in New Jersey. 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
$7.59
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.