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 $1.12 Median $1.12 Typical High $1.51 | Facility | None | $1.12 | $1.12 | $1.51 |
Aetna Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.45 | Professional | None | $1.12 | $1.12 | $1.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.98 Median $2.00 Typical High $8.51 | Professional | None | $0.98 | $2.00 | $8.51 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.09 Median $0.18 Typical High $0.81 | Professional | RR · Rental | $0.09 | $0.18 | $0.81 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.95 Median $1.51 Typical High $6.31 | Professional | UE · Used equipment | $0.95 | $1.51 | $6.31 |
CareSource Setting Facility Modifier None Typical Low $1.51 Median $1.51 Typical High $1.51 | Facility | None | $1.51 | $1.51 | $1.51 |
CareSource Setting Professional Modifier None Typical Low $1.51 Median $1.51 Typical High $1.51 | Professional | None | $1.51 | $1.51 | $1.51 |
Cigna Setting Facility Modifier None Typical Low $1.10 Median $1.10 Typical High $1.10 | Facility | None | $1.10 | $1.10 | $1.10 |
Cigna Setting Professional Modifier None Typical Low $0.93 Median $0.93 Typical High $2.45 | Professional | None | $0.93 | $0.93 | $2.45 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.29 Median $1.82 Typical High $186.21 | Professional | None | $1.29 | $1.82 | $186.21 |
United Setting Professional Modifier None Typical Low $0.60 Median $0.89 Typical High $2.14 | Professional | None | $0.60 | $0.89 | $2.14 |
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 $0.56 Median $0.56 Typical High $0.72 | Professional | 52 · Reduced service | $0.56 | $0.56 | $0.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.22 Median $0.23 Typical High $0.28 | Professional | 53 · Discontinued | $0.22 | $0.23 | $0.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.17 Median $0.17 Typical High $0.22 | Professional | 55 · Aftercare only | $0.17 | $0.17 | $0.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.11 Typical High $0.14 | Professional | 56 · Pre-op care only | $0.11 | $0.11 | $0.14 |
Where Georgia sits
The same service costs 2.1 times more in Hawaii than in New Jersey. 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· 4th of 51
$1.82
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.