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 $4.37 Median $4.37 Typical High $5.75 | Facility | None | $4.37 | $4.37 | $5.75 |
Aetna Setting Professional Modifier None Typical Low $4.07 Median $4.37 Typical High $5.50 | Professional | None | $4.07 | $4.37 | $5.50 |
Ambetter Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | None | $3.98 | $3.98 | $3.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.63 Median $6.03 Typical High $31.62 | Professional | None | $3.63 | $6.03 | $31.62 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.35 Median $0.71 Typical High $3.16 | Professional | RR · Rental | $0.35 | $0.71 | $3.16 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.57 Median $5.25 Typical High $23.99 | Professional | UE · Used equipment | $2.57 | $5.25 | $23.99 |
CareSource Setting Facility Modifier None Typical Low $5.89 Median $5.89 Typical High $5.89 | Facility | None | $5.89 | $5.89 | $5.89 |
CareSource Setting Professional Modifier None Typical Low $5.89 Median $8.91 Typical High $10.96 | Professional | None | $5.89 | $8.91 | $10.96 |
Cigna Setting Facility Modifier None Typical Low $4.17 Median $4.17 Typical High $4.47 | Facility | None | $4.17 | $4.17 | $4.47 |
Cigna Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $9.33 | Professional | None | $3.55 | $3.55 | $9.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.90 Median $7.08 Typical High $309.03 | Professional | None | $4.90 | $7.08 | $309.03 |
United Setting Professional Modifier None Typical Low $2.29 Median $3.47 Typical High $8.13 | Professional | None | $2.29 | $3.47 | $8.13 |
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 $0.65 Median $0.65 Typical High $0.81 | Professional | 55 · Aftercare only | $0.65 | $0.65 | $0.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.42 Median $0.44 Typical High $0.55 | Professional | 56 · Pre-op care only | $0.42 | $0.44 | $0.55 |
Where Georgia sits
The same service costs 2.1 times more in Kansas than in Colorado. 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· 14th of 51
$5.75
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.