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 $0.39 Median $0.39 Typical High $0.60 | Facility | None | $0.39 | $0.39 | $0.60 |
Aetna Setting Professional Modifier None Typical Low $0.38 Median $0.39 Typical High $0.43 | Professional | None | $0.38 | $0.39 | $0.43 |
Aetna Setting Professional Modifier RR · Rental Typical Low $0.04 Median $0.04 Typical High $0.05 | Professional | RR · Rental | $0.04 | $0.04 | $0.05 |
Ambetter Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.45 Median $0.85 Typical High $2.88 | Professional | None | $0.45 | $0.85 | $2.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.05 Median $0.18 Typical High $0.27 | Professional | RR · Rental | $0.05 | $0.18 | $0.27 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.34 Median $0.51 Typical High $2.14 | Professional | UE · Used equipment | $0.34 | $0.51 | $2.14 |
CareSource Setting Professional Modifier None Typical Low $0.52 Median $0.63 Typical High $0.91 | Professional | None | $0.52 | $0.63 | $0.91 |
Cigna Setting Professional Modifier None Typical Low $0.31 Median $0.31 Typical High $0.85 | Professional | None | $0.31 | $0.31 | $0.85 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.63 Median $0.63 Typical High $7.76 | Professional | None | $0.63 | $0.63 | $7.76 |
United Setting Professional Modifier None Typical Low $0.20 Median $0.31 Typical High $1.17 | Professional | None | $0.20 | $0.31 | $1.17 |
4 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 $0.19 Median $0.20 Typical High $0.22 | Professional | 52 · Reduced service | $0.19 | $0.20 | $0.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.08 Median $0.08 Typical High $0.09 | Professional | 53 · Discontinued | $0.08 | $0.08 | $0.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.06 Typical High $0.07 | Professional | 55 · Aftercare only | $0.06 | $0.06 | $0.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.04 |
Where Georgia sits
The same service costs 4.6 times more in Hawaii than in Rhode Island. 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· 10th of 51
$0.56
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.