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 $3.31 Median $3.31 Typical High $4.37 | Facility | None | $3.31 | $3.31 | $4.37 |
Aetna Setting Professional Modifier None Typical Low $3.24 Median $3.31 Typical High $4.17 | Professional | None | $3.24 | $3.31 | $4.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.75 Median $4.79 Typical High $23.99 | Professional | None | $2.75 | $4.79 | $23.99 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.26 Median $0.52 Typical High $2.40 | Professional | RR · Rental | $0.26 | $0.52 | $2.40 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.95 Median $3.98 Typical High $18.20 | Professional | UE · Used equipment | $1.95 | $3.98 | $18.20 |
CareSource Setting Facility Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Facility | None | $4.47 | $4.47 | $4.47 |
CareSource Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | None | $4.47 | $4.47 | $4.47 |
Cigna Setting Facility Modifier None Typical Low $3.16 Median $3.16 Typical High $3.63 | Facility | None | $3.16 | $3.16 | $3.63 |
Cigna Setting Professional Modifier None Typical Low $2.63 Median $2.63 Typical High $7.08 | Professional | None | $2.63 | $2.63 | $7.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.72 Median $5.37 Typical High $1,737.80 | Professional | None | $3.72 | $5.37 | $1,737.80 |
United Setting Professional Modifier None Typical Low $1.74 Median $2.57 Typical High $6.17 | Professional | None | $1.74 | $2.57 | $6.17 |
4 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 52 · Reduced service Typical Low $1.62 Median $1.66 Typical High $2.09 | Professional | 52 · Reduced service | $1.62 | $1.66 | $2.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.65 Median $0.66 Typical High $0.83 | Professional | 53 · Discontinued | $0.65 | $0.66 | $0.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.48 Median $0.50 Typical High $0.63 | Professional | 55 · Aftercare only | $0.48 | $0.50 | $0.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.32 Median $0.33 Typical High $0.42 | Professional | 56 · Pre-op care only | $0.32 | $0.33 | $0.42 |
Where Georgia sits
The same service costs 2.1 times more in Hawaii than in Connecticut. 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· 10th of 51
$4.57
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.