How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $5.62 Median $5.62 Typical High $7.41 | Facility | None | $5.62 | $5.62 | $7.41 |
Aetna Setting Professional Modifier None Typical Low $4.90 Median $5.62 Typical High $7.08 | Professional | None | $4.90 | $5.62 | $7.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.68 Median $7.76 Typical High $41.69 | Professional | None | $4.68 | $7.76 | $41.69 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.34 Median $0.91 Typical High $4.17 | Professional | RR · Rental | $0.34 | $0.91 | $4.17 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.57 Median $6.92 Typical High $31.62 | Professional | UE · Used equipment | $2.57 | $6.92 | $31.62 |
CareSource Setting Facility Modifier None Typical Low $6.46 Median $6.46 Typical High $6.46 | Facility | None | $6.46 | $6.46 | $6.46 |
CareSource Setting Professional Modifier None Typical Low $6.46 Median $10.00 Typical High $12.30 | Professional | None | $6.46 | $10.00 | $12.30 |
Cigna Setting Facility Modifier None Typical Low $5.37 Median $5.37 Typical High $5.37 | Facility | None | $5.37 | $5.37 | $5.37 |
Cigna Setting Professional Modifier None Typical Low $4.57 Median $4.57 Typical High $10.72 | Professional | None | $4.57 | $4.57 | $10.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $6.31 Median $8.91 Typical High $123.03 | Professional | None | $6.31 | $8.91 | $123.03 |
United Setting Professional Modifier None Typical Low $2.95 Median $4.37 Typical High $12.30 | Professional | None | $2.95 | $4.37 | $12.30 |
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 $0.81 Median $0.83 Typical High $1.07 | Professional | 55 · Aftercare only | $0.81 | $0.83 | $1.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.54 Median $0.56 Typical High $0.69 | Professional | 56 · Pre-op care only | $0.54 | $0.56 | $0.69 |
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $3.47 Median $4.57 Typical High $6.76 | Professional | KX · Policy requirements met | $3.47 | $4.57 | $6.76 |
Where Georgia sits
The same service costs 4.2 times more in Hawaii than in Kentucky. 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· 8th of 51
$7.76
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.