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 $3.02 Median $3.02 Typical High $3.98 | Facility | None | $3.02 | $3.02 | $3.98 |
Aetna Setting Professional Modifier None Typical Low $2.95 Median $3.02 Typical High $3.47 | Professional | None | $2.95 | $3.02 | $3.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.78 Median $4.37 Typical High $22.39 | Professional | None | $1.78 | $4.37 | $22.39 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.35 Median $0.49 Typical High $2.24 | Professional | RR · Rental | $0.35 | $0.49 | $2.24 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.63 Median $3.63 Typical High $16.60 | Professional | UE · Used equipment | $2.63 | $3.63 | $16.60 |
Cigna Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $6.46 | Professional | None | $2.00 | $2.00 | $6.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $69.18 | Professional | None | $4.90 | $4.90 | $69.18 |
Oscar Health Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $6.46 | Professional | None | $5.62 | $5.62 | $6.46 |
United Setting Professional Modifier None Typical Low $1.58 Median $2.40 Typical High $8.71 | Professional | None | $1.58 | $2.40 | $8.71 |
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 $1.48 Median $1.51 Typical High $1.74 | Professional | 52 · Reduced service | $1.48 | $1.51 | $1.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.59 Median $0.60 Typical High $0.69 | Professional | 53 · Discontinued | $0.59 | $0.60 | $0.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.44 Median $0.45 Typical High $0.51 | Professional | 55 · Aftercare only | $0.44 | $0.45 | $0.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.30 Typical High $0.34 | Professional | 56 · Pre-op care only | $0.28 | $0.30 | $0.34 |
Where Georgia sits
The same service costs 2.6 times more in Hawaii than in Maine. 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
$4.17
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.