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 $5.25 Median $5.25 Typical High $6.92 | Facility | None | $5.25 | $5.25 | $6.92 |
Aetna Setting Professional Modifier None Typical Low $5.13 Median $5.25 Typical High $6.76 | Professional | None | $5.13 | $5.25 | $6.76 |
Ambetter Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | None | $5.62 | $5.62 | $5.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.37 Median $7.41 Typical High $38.90 | Professional | None | $4.37 | $7.41 | $38.90 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.42 Median $0.85 Typical High $3.89 | Professional | RR · Rental | $0.42 | $0.85 | $3.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.16 Median $6.46 Typical High $29.51 | Professional | UE · Used equipment | $3.16 | $6.46 | $29.51 |
CareSource Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Facility | None | $7.08 | $7.08 | $7.08 |
CareSource Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | None | $7.08 | $7.08 | $7.08 |
Cigna Setting Facility Modifier None Typical Low $5.01 Median $5.01 Typical High $5.37 | Facility | None | $5.01 | $5.01 | $5.37 |
Cigna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $11.48 | Professional | None | $4.27 | $4.27 | $11.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $6.03 Median $8.51 Typical High $144.54 | Professional | None | $6.03 | $8.51 | $144.54 |
United Setting Professional Modifier None Typical Low $2.75 Median $4.17 Typical High $9.77 | Professional | None | $2.75 | $4.17 | $9.77 |
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 $0.78 Median $0.79 Typical High $1.00 | Professional | 55 · Aftercare only | $0.78 | $0.79 | $1.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.52 Typical High $0.68 | Professional | 56 · Pre-op care only | $0.52 | $0.52 | $0.68 |
Where Georgia sits
The same service costs 2.1 times more in Hawaii 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· 14th of 51
$6.92
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.