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 $2.75 Median $2.75 Typical High $4.27 | Facility | None | $2.75 | $2.75 | $4.27 |
Aetna Setting Professional Modifier None Typical Low $2.69 Median $2.75 Typical High $3.09 | Professional | None | $2.69 | $2.75 | $3.09 |
Aetna Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | AU · Urologic/ostomy supply | $1.20 | $1.20 | $1.20 |
Ambetter Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | None | $3.39 | $3.39 | $3.39 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.29 Median $3.89 Typical High $8.51 | Professional | None | $2.29 | $3.89 | $8.51 |
Anthem BCBS Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $3.80 Median $4.47 Typical High $20.42 | Professional | AU · Urologic/ostomy supply | $3.80 | $4.47 | $20.42 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.32 Median $0.45 Typical High $2.04 | Professional | RR · Rental | $0.32 | $0.45 | $2.04 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.29 Median $3.39 Typical High $15.14 | Professional | UE · Used equipment | $2.29 | $3.39 | $15.14 |
CareSource Setting Professional Modifier None Typical Low $3.72 Median $5.25 Typical High $5.89 | Professional | None | $3.72 | $5.25 | $5.89 |
Cigna Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | None | $2.24 | $2.24 | $2.24 |
Cigna Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $5.37 Median $6.03 Typical High $6.03 | Professional | AU · Urologic/ostomy supply | $5.37 | $6.03 | $6.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $97.72 | Professional | None | $4.47 | $4.47 | $97.72 |
Kaiser Permanente Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $4.47 Median $4.47 Typical High $5.37 | Professional | AU · Urologic/ostomy supply | $4.47 | $4.47 | $5.37 |
United Setting Professional Modifier None Typical Low $1.45 Median $2.19 Typical High $9.33 | Professional | None | $1.45 | $2.19 | $9.33 |
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 $1.35 Median $1.38 Typical High $1.55 | Professional | 52 · Reduced service | $1.35 | $1.38 | $1.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.54 Median $0.55 Typical High $0.62 | Professional | 53 · Discontinued | $0.54 | $0.55 | $0.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.41 Median $0.42 Typical High $0.47 | Professional | 55 · Aftercare only | $0.41 | $0.42 | $0.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.27 Median $0.28 Typical High $0.31 | Professional | 56 · Pre-op care only | $0.27 | $0.28 | $0.31 |
Where Georgia sits
The same service costs 4.4 times more in Minnesota than in New Hampshire. 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· 9th of 51
$3.63
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.