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 $7.24 Median $7.24 Typical High $7.94 | Facility | None | $7.24 | $7.24 | $7.94 |
Aetna Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $7.94 | Professional | None | $7.24 | $7.24 | $7.94 |
Anthem BCBS Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | None | $11.48 | $11.48 | $11.48 |
CareFirst Setting Professional Modifier None Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | None | $6.61 | $6.61 | $6.61 |
Cigna Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | None | $4.90 | $4.90 | $4.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $10.00 Median $13.18 Typical High $19.05 | Professional | None | $10.00 | $13.18 | $19.05 |
Medcost Setting Facility Modifier None Typical Low $7.24 Median $17.38 Typical High $20.89 | Facility | None | $7.24 | $17.38 | $20.89 |
Medcost Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $10.00 | Professional | None | $6.46 | $6.46 | $10.00 |
Sentara Setting Facility Modifier None Typical Low $8.91 Median $19.50 Typical High $10,232.93 | Facility | None | $8.91 | $19.50 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $6.92 Median $17.38 Typical High $28.84 | Professional | None | $6.92 | $17.38 | $28.84 |
United Setting Professional Modifier None Typical Low $5.01 Median $5.75 Typical High $8.51 | Professional | None | $5.01 | $5.75 | $8.51 |
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 $3.63 Median $3.63 Typical High $3.98 | Professional | 52 · Reduced service | $3.63 | $3.63 | $3.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.45 Median $1.45 Typical High $1.58 | Professional | 53 · Discontinued | $1.45 | $1.45 | $1.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $5.37 Median $5.37 Typical High $5.89 | Professional | 54 · Surgery only | $5.37 | $5.37 | $5.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.07 Median $1.07 Typical High $1.17 | Professional | 55 · Aftercare only | $1.07 | $1.07 | $1.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.72 Median $0.72 Typical High $0.79 | Professional | 56 · Pre-op care only | $0.72 | $0.72 | $0.79 |
Where Virginia sits
The same service costs 2.9 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
$7.94
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.