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 $2.63 Median $2.63 Typical High $3.47 | Facility | None | $2.63 | $2.63 | $3.47 |
Aetna Setting Professional Modifier None Typical Low $2.51 Median $2.63 Typical High $3.47 | Professional | None | $2.51 | $2.63 | $3.47 |
Ambetter Setting Professional Modifier None Typical Low $2.75 Median $2.75 Typical High $2.75 | Professional | None | $2.75 | $2.75 | $2.75 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.40 Median $3.63 Typical High $22.39 | Professional | None | $2.40 | $3.63 | $22.39 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.24 Median $0.50 Typical High $4.90 | Professional | RR · Rental | $0.24 | $0.50 | $4.90 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.82 Median $3.02 Typical High $16.98 | Professional | UE · Used equipment | $1.82 | $3.02 | $16.98 |
CareSource Setting Facility Modifier None Typical Low $3.80 Median $3.80 Typical High $3.80 | Facility | None | $3.80 | $3.80 | $3.80 |
CareSource Setting Professional Modifier None Typical Low $3.80 Median $5.75 Typical High $7.08 | Professional | None | $3.80 | $5.75 | $7.08 |
Cigna Setting Facility Modifier None Typical Low $2.95 Median $2.95 Typical High $3.09 | Facility | None | $2.95 | $2.95 | $3.09 |
Cigna Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $5.62 | Professional | None | $2.45 | $2.45 | $5.62 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.95 Median $4.17 Typical High $131.83 | Professional | None | $2.95 | $4.17 | $131.83 |
United Setting Professional Modifier None Typical Low $1.38 Median $2.04 Typical High $4.79 | Professional | None | $1.38 | $2.04 | $4.79 |
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 $0.38 Median $0.39 Typical High $0.51 | Professional | 55 · Aftercare only | $0.38 | $0.39 | $0.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.25 Median $0.26 Typical High $0.34 | Professional | 56 · Pre-op care only | $0.25 | $0.26 | $0.34 |
Where Georgia sits
The same service costs 5.5 times more in Kansas 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· 21st of 51
$3.47
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.