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 $5.01 Median $5.01 Typical High $6.61 | Facility | None | $5.01 | $5.01 | $6.61 |
Aetna Setting Professional Modifier None Typical Low $4.57 Median $5.01 Typical High $6.46 | Professional | None | $4.57 | $5.01 | $6.46 |
Ambetter Setting Professional Modifier None Typical Low $4.17 Median $4.17 Typical High $4.17 | Professional | None | $4.17 | $4.17 | $4.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.27 Median $7.08 Typical High $37.15 | Professional | None | $4.27 | $7.08 | $37.15 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.40 Median $0.79 Typical High $3.72 | Professional | RR · Rental | $0.40 | $0.79 | $3.72 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.02 Median $6.17 Typical High $28.18 | Professional | UE · Used equipment | $3.02 | $6.17 | $28.18 |
CareSource Setting Facility Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Facility | None | $6.76 | $6.76 | $6.76 |
CareSource Setting Professional Modifier None Typical Low $6.76 Median $10.47 Typical High $12.88 | Professional | None | $6.76 | $10.47 | $12.88 |
Cigna Setting Facility Modifier None Typical Low $4.79 Median $4.79 Typical High $5.13 | Facility | None | $4.79 | $4.79 | $5.13 |
Cigna Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $10.96 | Professional | None | $4.07 | $4.07 | $10.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5.75 Median $8.13 Typical High $70.79 | Professional | None | $5.75 | $8.13 | $70.79 |
United Setting Professional Modifier None Typical Low $2.63 Median $3.98 Typical High $9.33 | Professional | None | $2.63 | $3.98 | $9.33 |
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 $0.74 Median $0.76 Typical High $0.95 | Professional | 55 · Aftercare only | $0.74 | $0.76 | $0.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.49 Median $0.51 Typical High $0.65 | Professional | 56 · Pre-op care only | $0.49 | $0.51 | $0.65 |
Where Georgia sits
The same service costs 2.3 times more in Kansas than in Utah. 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
$6.61
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.