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 $6.17 Median $6.17 Typical High $8.13 | Facility | None | $6.17 | $6.17 | $8.13 |
Aetna Setting Professional Modifier None Typical Low $6.03 Median $6.17 Typical High $6.92 | Professional | None | $6.03 | $6.17 | $6.92 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.13 Median $8.71 Typical High $50.12 | Professional | None | $5.13 | $8.71 | $50.12 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.68 Median $1.10 Typical High $5.01 | Professional | RR · Rental | $0.68 | $1.10 | $5.01 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $5.13 Median $8.32 Typical High $38.02 | Professional | UE · Used equipment | $5.13 | $8.32 | $38.02 |
Cigna Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $13.18 | Professional | None | $5.50 | $5.50 | $13.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $87.10 | Professional | None | $9.77 | $9.77 | $87.10 |
United Setting Professional Modifier None Typical Low $3.24 Median $4.79 Typical High $17.78 | Professional | None | $3.24 | $4.79 | $17.78 |
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 $0.89 Median $0.91 Typical High $1.05 | Professional | 55 · Aftercare only | $0.89 | $0.91 | $1.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.60 Median $0.62 Typical High $0.69 | Professional | 56 · Pre-op care only | $0.60 | $0.62 | $0.69 |
Where Georgia sits
The same service costs 3.3 times more in Hawaii than in Utah. 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· 15th of 51
$8.51
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.