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 $2.63 Median $2.63 Typical High $2.88 | Facility | None | $2.63 | $2.63 | $2.88 |
Aetna Setting Professional Modifier None Typical Low $2.63 Median $2.63 Typical High $2.88 | Professional | None | $2.63 | $2.63 | $2.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.17 Median $4.17 Typical High $4.17 | Professional | None | $4.17 | $4.17 | $4.17 |
CareFirst Setting Professional Modifier None Typical Low $2.40 Median $2.40 Typical High $2.40 | Professional | None | $2.40 | $2.40 | $2.40 |
Cigna Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $1.78 | Professional | None | $1.78 | $1.78 | $1.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.63 Median $4.79 Typical High $6.92 | Professional | None | $3.63 | $4.79 | $6.92 |
Medcost Setting Facility Modifier None Typical Low $2.63 Median $6.31 Typical High $10.72 | Facility | None | $2.63 | $6.31 | $10.72 |
Medcost Setting Professional Modifier None Typical Low $2.34 Median $2.34 Typical High $7.59 | Professional | None | $2.34 | $2.34 | $7.59 |
Sentara Setting Facility Modifier None Typical Low $3.80 Median $8.32 Typical High $10,232.93 | Facility | None | $3.80 | $8.32 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $2.51 Median $8.13 Typical High $14.79 | Professional | None | $2.51 | $8.13 | $14.79 |
United Setting Professional Modifier None Typical Low $1.82 Median $2.09 Typical High $3.09 | Professional | None | $1.82 | $2.09 | $3.09 |
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 $1.32 Median $1.32 Typical High $1.45 | Professional | 52 · Reduced service | $1.32 | $1.32 | $1.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.52 Median $0.52 Typical High $0.56 | Professional | 53 · Discontinued | $0.52 | $0.52 | $0.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1.95 Median $1.95 Typical High $2.14 | Professional | 54 · Surgery only | $1.95 | $1.95 | $2.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.39 Median $0.39 Typical High $0.43 | Professional | 55 · Aftercare only | $0.39 | $0.39 | $0.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.26 Median $0.26 Typical High $0.28 | Professional | 56 · Pre-op care only | $0.26 | $0.26 | $0.28 |
Where Virginia sits
The same service costs 4.0 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· 26th of 51
$2.88
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.