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 $3.02 Median $3.02 Typical High $3.98 | Facility | None | $3.02 | $3.02 | $3.98 |
Aetna Setting Professional Modifier None Typical Low $2.95 Median $3.02 Typical High $3.80 | Professional | None | $2.95 | $3.02 | $3.80 |
Ambetter Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | None | $3.16 | $3.16 | $3.16 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.51 Median $4.27 Typical High $22.39 | Professional | None | $2.51 | $4.27 | $22.39 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.24 Median $0.49 Typical High $2.24 | Professional | RR · Rental | $0.24 | $0.49 | $2.24 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.78 Median $3.63 Typical High $16.60 | Professional | UE · Used equipment | $1.78 | $3.63 | $16.60 |
CareSource Setting Facility Modifier None Typical Low $4.07 Median $4.07 Typical High $4.07 | Facility | None | $4.07 | $4.07 | $4.07 |
CareSource Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | None | $4.07 | $4.07 | $4.07 |
Cigna Setting Facility Modifier None Typical Low $2.88 Median $2.88 Typical High $3.02 | Facility | None | $2.88 | $2.88 | $3.02 |
Cigna Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $6.46 | Professional | None | $2.45 | $2.45 | $6.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.39 Median $4.90 Typical High $218.78 | Professional | None | $3.39 | $4.90 | $218.78 |
United Setting Professional Modifier None Typical Low $1.58 Median $2.40 Typical High $5.62 | Professional | None | $1.58 | $2.40 | $5.62 |
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 $0.44 Median $0.45 Typical High $0.56 | Professional | 55 · Aftercare only | $0.44 | $0.45 | $0.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.30 Typical High $0.38 | Professional | 56 · Pre-op care only | $0.30 | $0.30 | $0.38 |
Where Georgia sits
The same service costs 2.8 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· 13th of 51
$3.98
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.