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 $7.94 Median $7.94 Typical High $10.47 | Facility | None | $7.94 | $7.94 | $10.47 |
Aetna Setting Professional Modifier None Typical Low $7.76 Median $7.94 Typical High $10.00 | Professional | None | $7.76 | $7.94 | $10.00 |
Ambetter Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $11.48 | Professional | None | $8.32 | $8.32 | $11.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.61 Median $11.22 Typical High $58.88 | Professional | None | $6.61 | $11.22 | $58.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.63 Median $1.29 Typical High $5.89 | Professional | RR · Rental | $0.63 | $1.29 | $5.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.79 Median $9.55 Typical High $43.65 | Professional | UE · Used equipment | $4.79 | $9.55 | $43.65 |
CareSource Setting Facility Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Facility | None | $10.72 | $10.72 | $10.72 |
CareSource Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | None | $10.72 | $10.72 | $10.72 |
Cigna Setting Facility Modifier None Typical Low $7.59 Median $7.59 Typical High $7.94 | Facility | None | $7.59 | $7.59 | $7.94 |
Cigna Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $17.38 | Professional | None | $6.46 | $6.46 | $17.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $9.12 Median $12.88 Typical High $165.96 | Professional | None | $9.12 | $12.88 | $165.96 |
United Setting Professional Modifier None Typical Low $4.17 Median $6.31 Typical High $14.79 | Professional | None | $4.17 | $6.31 | $14.79 |
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 $1.17 Median $1.20 Typical High $1.51 | Professional | 55 · Aftercare only | $1.17 | $1.20 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.78 Median $0.79 Typical High $1.00 | Professional | 56 · Pre-op care only | $0.78 | $0.79 | $1.00 |
Where Georgia sits
The same service costs 2.1 times more in Idaho than in New Jersey. 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
$10.47
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.