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 $1.20 Median $1.20 Typical High $1.58 | Facility | None | $1.20 | $1.20 | $1.58 |
Aetna Setting Professional Modifier None Typical Low $1.17 Median $1.20 Typical High $1.66 | Professional | None | $1.17 | $1.20 | $1.66 |
Ambetter Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.17 Median $1.70 Typical High $10.23 | Professional | None | $1.17 | $1.70 | $10.23 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.11 Median $0.23 Typical High $1.00 | Professional | RR · Rental | $0.11 | $0.23 | $1.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.83 Median $1.66 Typical High $7.76 | Professional | UE · Used equipment | $0.83 | $1.66 | $7.76 |
CareSource Setting Facility Modifier None Typical Low $1.62 Median $1.62 Typical High $1.62 | Facility | None | $1.62 | $1.62 | $1.62 |
CareSource Setting Professional Modifier None Typical Low $1.62 Median $1.62 Typical High $1.62 | Professional | None | $1.62 | $1.62 | $1.62 |
Cigna Setting Facility Modifier None Typical Low $0.72 Median $1.35 Typical High $1.35 | Facility | None | $0.72 | $1.35 | $1.35 |
Cigna Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $2.57 | Professional | None | $1.12 | $1.12 | $2.57 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.35 Median $1.95 Typical High $23.99 | Professional | None | $1.35 | $1.95 | $23.99 |
United Setting Professional Modifier None Typical Low $0.65 Median $0.95 Typical High $2.24 | Professional | None | $0.65 | $0.95 | $2.24 |
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 $0.18 Median $0.18 Typical High $0.24 | Professional | 55 · Aftercare only | $0.18 | $0.18 | $0.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.12 Median $0.12 Typical High $0.16 | Professional | 56 · Pre-op care only | $0.12 | $0.12 | $0.16 |
Where Georgia sits
The same service costs 5.8 times more in Hawaii than in Rhode Island. 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· 19th of 51
$1.58
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.