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 $3.24 Median $3.24 Typical High $4.27 | Facility | None | $3.24 | $3.24 | $4.27 |
Aetna Setting Professional Modifier None Typical Low $2.88 Median $3.24 Typical High $4.07 | Professional | None | $2.88 | $3.24 | $4.07 |
Ambetter Setting Professional Modifier None Typical Low $2.63 Median $2.63 Typical High $2.63 | Professional | None | $2.63 | $2.63 | $2.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.69 Median $4.47 Typical High $23.44 | Professional | None | $2.69 | $4.47 | $23.44 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.26 Median $0.50 Typical High $2.34 | Professional | RR · Rental | $0.26 | $0.50 | $2.34 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.91 Median $3.89 Typical High $17.78 | Professional | UE · Used equipment | $1.91 | $3.89 | $17.78 |
CareSource Setting Facility Modifier None Typical Low $4.37 Median $4.37 Typical High $4.37 | Facility | None | $4.37 | $4.37 | $4.37 |
CareSource Setting Professional Modifier None Typical Low $4.37 Median $6.61 Typical High $8.13 | Professional | None | $4.37 | $6.61 | $8.13 |
Cigna Setting Facility Modifier None Typical Low $3.09 Median $3.09 Typical High $3.24 | Facility | None | $3.09 | $3.09 | $3.24 |
Cigna Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $6.92 | Professional | None | $2.57 | $2.57 | $6.92 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.63 Median $5.25 Typical High $234.42 | Professional | None | $3.63 | $5.25 | $234.42 |
United Setting Professional Modifier None Typical Low $1.70 Median $2.51 Typical High $6.03 | Professional | None | $1.70 | $2.51 | $6.03 |
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 $0.47 Median $0.48 Typical High $0.62 | Professional | 55 · Aftercare only | $0.47 | $0.48 | $0.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.31 Median $0.32 Typical High $0.41 | Professional | 56 · Pre-op care only | $0.31 | $0.32 | $0.41 |
Where Georgia sits
The same service costs 3.2 times more in Kansas than in Missouri. 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· 14th of 51
$4.27
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.