How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $0.48 Median $0.48 Typical High $0.48 | Facility | None | $0.48 | $0.48 | $0.48 |
Aetna Setting Professional Modifier None Typical Low $0.48 Median $0.48 Typical High $0.48 | Professional | None | $0.48 | $0.48 | $0.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.45 Median $0.45 Typical High $0.47 | Professional | None | $0.45 | $0.45 | $0.47 |
CareFirst Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.26 | Professional | None | $1.26 | $1.26 | $1.26 |
Cigna Setting Facility Modifier None Typical Low $0.50 Median $0.83 Typical High $1.20 | Facility | None | $0.50 | $0.83 | $1.20 |
Cigna Setting Professional Modifier None Typical Low $0.48 Median $0.48 Typical High $0.48 | Professional | None | $0.48 | $0.48 | $0.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.66 Median $0.79 Typical High $1.02 | Professional | None | $0.66 | $0.79 | $1.02 |
Medcost Setting Professional Modifier None Typical Low $0.20 Median $0.20 Typical High $0.71 | Professional | None | $0.20 | $0.20 | $0.71 |
Medcost Setting Facility Modifier None Typical Low $0.56 Median $0.56 Typical High $0.72 | Facility | None | $0.56 | $0.56 | $0.72 |
Medcost Setting Professional Modifier None Typical Low $0.52 Median $0.63 Typical High $1.00 | Professional | None | $0.52 | $0.63 | $1.00 |
Sentara Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $1.95 | Professional | None | $1.95 | $1.95 | $1.95 |
United Setting Professional Modifier None Typical Low $0.47 Median $0.47 Typical High $0.48 | Professional | None | $0.47 | $0.47 | $0.48 |
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 $0.24 Median $0.24 Typical High $0.24 | Professional | 52 · Reduced service | $0.24 | $0.24 | $0.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.10 Median $0.10 Typical High $0.10 | Professional | 53 · Discontinued | $0.10 | $0.10 | $0.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 55 · Aftercare only | $0.07 | $0.07 | $0.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.05 | $0.05 | $0.05 |
Where Virginia sits
The same service costs 2.3 times more in Montana than in Michigan. 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
$0.48
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.