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 $4.47 Median $4.47 Typical High $5.25 | Facility | None | $4.47 | $4.47 | $5.25 |
Aetna Setting Professional Modifier None Typical Low $3.89 Median $4.47 Typical High $5.25 | Professional | None | $3.89 | $4.47 | $5.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.17 Median $6.46 Typical High $10.47 | Professional | None | $4.17 | $6.46 | $10.47 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.54 Median $0.68 Typical High $1.05 | Professional | RR · Rental | $0.54 | $0.68 | $1.05 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.07 Median $5.13 Typical High $7.24 | Professional | UE · Used equipment | $4.07 | $5.13 | $7.24 |
CareSource Setting Professional Modifier None Typical Low $5.01 Median $6.76 Typical High $7.76 | Professional | None | $5.01 | $6.76 | $7.76 |
Cigna Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | None | $1.29 | $1.29 | $1.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5.62 Median $125.89 Typical High $125.89 | Professional | None | $5.62 | $125.89 | $125.89 |
United Setting Professional Modifier None Typical Low $2.45 Median $3.63 Typical High $11.48 | Professional | None | $2.45 | $3.63 | $11.48 |
2 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 55 · Aftercare only Typical Low $0.58 Median $0.68 Typical High $0.68 | Professional | 55 · Aftercare only | $0.58 | $0.68 | $0.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.39 Median $0.45 Typical High $0.45 | Professional | 56 · Pre-op care only | $0.39 | $0.45 | $0.45 |
Where Georgia sits
The same service costs 3.2 times more in Montana than in Colorado. 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.
Georgia· 11th of 51
$5.62
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.