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 $1.58 Median $1.58 Typical High $2.09 | Facility | None | $1.58 | $1.58 | $2.09 |
Aetna Setting Professional Modifier None Typical Low $1.55 Median $1.58 Typical High $2.04 | Professional | None | $1.55 | $1.58 | $2.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.26 Median $2.24 Typical High $11.75 | Professional | None | $1.26 | $2.24 | $11.75 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.13 Median $0.25 Typical High $1.17 | Professional | RR · Rental | $0.13 | $0.25 | $1.17 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.95 Median $2.09 Typical High $8.91 | Professional | UE · Used equipment | $0.95 | $2.09 | $8.91 |
CareSource Setting Facility Modifier None Typical Low $2.14 Median $2.14 Typical High $2.14 | Facility | None | $2.14 | $2.14 | $2.14 |
CareSource Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $2.14 | Professional | None | $2.14 | $2.14 | $2.14 |
Cigna Setting Facility Modifier None Typical Low $1.70 Median $1.70 Typical High $1.70 | Facility | None | $1.70 | $1.70 | $1.70 |
Cigna Setting Professional Modifier None Typical Low $1.45 Median $1.45 Typical High $3.47 | Professional | None | $1.45 | $1.45 | $3.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.82 Median $2.57 Typical High $1,995.26 | Professional | None | $1.82 | $2.57 | $1,995.26 |
United Setting Professional Modifier None Typical Low $0.83 Median $1.26 Typical High $2.95 | Professional | None | $0.83 | $1.26 | $2.95 |
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 $0.78 Median $0.79 Typical High $1.00 | Professional | 52 · Reduced service | $0.78 | $0.79 | $1.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.31 Median $0.32 Typical High $0.40 | Professional | 53 · Discontinued | $0.31 | $0.32 | $0.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.23 Median $0.24 Typical High $0.30 | Professional | 55 · Aftercare only | $0.23 | $0.24 | $0.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.16 Median $0.16 Typical High $0.20 | Professional | 56 · Pre-op care only | $0.16 | $0.16 | $0.20 |
Where Georgia sits
The same service costs 2.3 times more in Kansas 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· 15th of 51
$2.04
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.