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 $4.17 Median $4.17 Typical High $5.50 | Facility | None | $4.17 | $4.17 | $5.50 |
Aetna Setting Professional Modifier None Typical Low $4.07 Median $4.17 Typical High $5.37 | Professional | None | $4.07 | $4.17 | $5.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.47 Median $6.03 Typical High $34.67 | Professional | None | $3.47 | $6.03 | $34.67 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.47 Median $0.76 Typical High $3.47 | Professional | RR · Rental | $0.47 | $0.76 | $3.47 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.24 Median $5.50 Typical High $26.30 | Professional | UE · Used equipment | $3.24 | $5.50 | $26.30 |
Cigna Setting Professional Modifier None Typical Low $3.80 Median $3.80 Typical High $9.12 | Professional | None | $3.80 | $3.80 | $9.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $54.95 | Professional | None | $6.76 | $6.76 | $54.95 |
United Setting Professional Modifier None Typical Low $2.19 Median $3.31 Typical High $12.02 | Professional | None | $2.19 | $3.31 | $12.02 |
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 $0.62 Median $0.63 Typical High $0.79 | Professional | 55 · Aftercare only | $0.62 | $0.63 | $0.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.41 Median $0.42 Typical High $0.54 | Professional | 56 · Pre-op care only | $0.41 | $0.42 | $0.54 |
Where Georgia sits
The same service costs 2.5 times more in Idaho than in Colorado. 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· 13th of 51
$5.89
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.