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 $1.58 Median $1.58 Typical High $1.82 | Facility | None | $1.58 | $1.58 | $1.82 |
Aetna Setting Professional Modifier None Typical Low $1.35 Median $1.58 Typical High $1.58 | Professional | None | $1.35 | $1.58 | $1.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.04 Median $2.69 Typical High $3.39 | Professional | None | $2.04 | $2.69 | $3.39 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.22 Median $0.27 Typical High $0.40 | Professional | RR · Rental | $0.22 | $0.27 | $0.40 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.62 Median $2.04 Typical High $3.02 | Professional | UE · Used equipment | $1.62 | $2.04 | $3.02 |
Cigna Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | None | $3.98 | $3.98 | $3.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.34 Median $2.82 Typical High $52.48 | Professional | None | $2.34 | $2.82 | $52.48 |
United Setting Professional Modifier None Typical Low $0.85 Median $1.29 Typical High $4.27 | Professional | None | $0.85 | $1.29 | $4.27 |
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 $0.20 Median $0.24 Typical High $0.24 | Professional | 55 · Aftercare only | $0.20 | $0.24 | $0.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.16 Typical High $0.16 | Professional | 56 · Pre-op care only | $0.14 | $0.16 | $0.16 |
Where Georgia sits
The same service costs 6.0 times more in Minnesota 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· 9th of 51
$2.69
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.