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 $1.07 Median $1.07 Typical High $1.41 | Facility | None | $1.07 | $1.07 | $1.41 |
Aetna Setting Professional Modifier None Typical Low $1.05 Median $1.07 Typical High $1.20 | Professional | None | $1.05 | $1.07 | $1.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.26 Median $2.63 Typical High $10.00 | Professional | None | $1.26 | $2.63 | $10.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.91 Median $1.26 Typical High $4.90 | Professional | UE · Used equipment | $0.91 | $1.26 | $4.90 |
Cigna Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $2.00 | Professional | None | $1.02 | $1.02 | $2.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.41 Median $1.41 Typical High $89.13 | Professional | None | $1.41 | $1.41 | $89.13 |
United Setting Professional Modifier None Typical Low $0.56 Median $1.41 Typical High $9.55 | Professional | None | $0.56 | $1.41 | $9.55 |
3 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 $0.16 Median $0.16 Typical High $0.18 | Professional | 55 · Aftercare only | $0.16 | $0.16 | $0.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.11 Typical High $0.12 | Professional | 56 · Pre-op care only | $0.11 | $0.11 | $0.12 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.63 Median $0.63 Typical High $0.63 | Professional | RR · Rental | $0.63 | $0.63 | $0.63 |
Where Georgia sits
The same service costs 7.4 times more in Kentucky than in Delaware. 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
$1.66
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.