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 $4.07 Median $4.07 Typical High $5.37 | Facility | None | $4.07 | $4.07 | $5.37 |
Aetna Setting Professional Modifier None Typical Low $3.98 Median $4.07 Typical High $5.13 | Professional | None | $3.98 | $4.07 | $5.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.24 Median $5.75 Typical High $30.20 | Professional | None | $3.24 | $5.75 | $30.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.32 Median $0.66 Typical High $3.02 | Professional | RR · Rental | $0.32 | $0.66 | $3.02 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.40 Median $4.68 Typical High $22.39 | Professional | UE · Used equipment | $2.40 | $4.68 | $22.39 |
CareSource Setting Facility Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Facility | None | $5.50 | $5.50 | $5.50 |
CareSource Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | None | $5.50 | $5.50 | $5.50 |
Cigna Setting Facility Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Facility | None | $3.89 | $3.89 | $3.89 |
Cigna Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $8.91 | Professional | None | $3.31 | $3.31 | $8.91 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.57 Median $6.61 Typical High $1,995.26 | Professional | None | $4.57 | $6.61 | $1,995.26 |
United Setting Professional Modifier None Typical Low $2.14 Median $3.24 Typical High $7.59 | Professional | None | $2.14 | $3.24 | $7.59 |
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 $0.60 Median $0.62 Typical High $0.78 | Professional | 55 · Aftercare only | $0.60 | $0.62 | $0.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.40 Median $0.41 Typical High $0.52 | Professional | 56 · Pre-op care only | $0.40 | $0.41 | $0.52 |
Where Georgia sits
The same service costs 2.6 times more in Kansas than in New Hampshire. 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· 15th of 51
$5.37
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.