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 $3.55 Median $3.55 Typical High $3.89 | Facility | None | $3.55 | $3.55 | $3.89 |
Aetna Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.89 | Professional | None | $3.55 | $3.55 | $3.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | None | $5.62 | $5.62 | $5.62 |
CareFirst Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | None | $3.24 | $3.24 | $3.24 |
Cigna Setting Professional Modifier None Typical Low $2.34 Median $2.34 Typical High $2.34 | Professional | None | $2.34 | $2.34 | $2.34 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.90 Median $6.31 Typical High $9.33 | Professional | None | $4.90 | $6.31 | $9.33 |
Medcost Setting Facility Modifier None Typical Low $3.55 Median $8.51 Typical High $10.72 | Facility | None | $3.55 | $8.51 | $10.72 |
Medcost Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $8.91 | Professional | None | $3.09 | $3.09 | $8.91 |
Sentara Setting Facility Modifier None Typical Low $4.37 Median $10.47 Typical High $10,232.93 | Facility | None | $4.37 | $10.47 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $3.39 Median $8.71 Typical High $14.79 | Professional | None | $3.39 | $8.71 | $14.79 |
United Setting Professional Modifier None Typical Low $2.45 Median $2.82 Typical High $4.07 | Professional | None | $2.45 | $2.82 | $4.07 |
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 $1.78 Median $1.78 Typical High $1.95 | Professional | 52 · Reduced service | $1.78 | $1.78 | $1.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.71 Median $0.71 Typical High $0.78 | Professional | 53 · Discontinued | $0.71 | $0.71 | $0.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2.63 Median $2.63 Typical High $2.88 | Professional | 54 · Surgery only | $2.63 | $2.63 | $2.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.52 Typical High $0.58 | Professional | 55 · Aftercare only | $0.52 | $0.52 | $0.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.35 Median $0.35 Typical High $0.39 | Professional | 56 · Pre-op care only | $0.35 | $0.35 | $0.39 |
Where Virginia sits
The same service costs 3.0 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· 25th of 51
$3.89
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.