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 $3.31 Median $3.31 Typical High $3.63 | Facility | None | $3.31 | $3.31 | $3.63 |
Aetna Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $3.63 | Professional | None | $3.31 | $3.31 | $3.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | None | $5.25 | $5.25 | $5.25 |
CareFirst Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $3.09 | Professional | None | $3.09 | $3.09 | $3.09 |
Cigna Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | None | $2.24 | $2.24 | $2.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.68 Median $6.03 Typical High $8.71 | Professional | None | $4.68 | $6.03 | $8.71 |
Medcost Setting Facility Modifier None Typical Low $3.31 Median $7.94 Typical High $12.59 | Facility | None | $3.31 | $7.94 | $12.59 |
Medcost Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $7.59 | Professional | None | $2.95 | $2.95 | $7.59 |
Sentara Setting Facility Modifier None Typical Low $4.79 Median $10.72 Typical High $10,232.93 | Facility | None | $4.79 | $10.72 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $3.16 Median $10.00 Typical High $18.20 | Professional | None | $3.16 | $10.00 | $18.20 |
United Setting Professional Modifier None Typical Low $2.34 Median $2.69 Typical High $3.89 | Professional | None | $2.34 | $2.69 | $3.89 |
5 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 $1.66 Median $1.66 Typical High $1.82 | Professional | 52 · Reduced service | $1.66 | $1.66 | $1.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.68 Median $0.68 Typical High $0.72 | Professional | 53 · Discontinued | $0.68 | $0.68 | $0.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2.51 Median $2.51 Typical High $2.75 | Professional | 54 · Surgery only | $2.51 | $2.51 | $2.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.50 Median $0.50 Typical High $0.55 | Professional | 55 · Aftercare only | $0.50 | $0.50 | $0.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.33 Median $0.33 Typical High $0.36 | Professional | 56 · Pre-op care only | $0.33 | $0.33 | $0.36 |
Where Virginia sits
The same service costs 3.8 times more in Rhode Island than in New York. 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· 26th of 51
$3.63
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.