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 $2.45 Median $2.45 Typical High $3.24 | Facility | None | $2.45 | $2.45 | $3.24 |
Aetna Setting Professional Modifier None Typical Low $2.40 Median $2.45 Typical High $3.09 | Professional | None | $2.40 | $2.45 | $3.09 |
Ambetter Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | None | $2.57 | $2.57 | $2.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.04 Median $3.47 Typical High $18.20 | Professional | None | $2.04 | $3.47 | $18.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.20 Median $0.40 Typical High $1.82 | Professional | RR · Rental | $0.20 | $0.40 | $1.82 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.45 Median $3.02 Typical High $13.49 | Professional | UE · Used equipment | $1.45 | $3.02 | $13.49 |
CareSource Setting Facility Modifier None Typical Low $3.31 Median $3.31 Typical High $3.31 | Facility | None | $3.31 | $3.31 | $3.31 |
CareSource Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $3.31 | Professional | None | $3.31 | $3.31 | $3.31 |
Cigna Setting Facility Modifier None Typical Low $2.34 Median $2.34 Typical High $2.51 | Facility | None | $2.34 | $2.34 | $2.51 |
Cigna Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $5.37 | Professional | None | $2.00 | $2.00 | $5.37 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.82 Median $3.98 Typical High $3,311.31 | Professional | None | $2.82 | $3.98 | $3,311.31 |
United Setting Professional Modifier None Typical Low $1.29 Median $1.95 Typical High $4.57 | Professional | None | $1.29 | $1.95 | $4.57 |
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 $1.20 Median $1.23 Typical High $1.55 | Professional | 52 · Reduced service | $1.20 | $1.23 | $1.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.48 Median $0.49 Typical High $0.62 | Professional | 53 · Discontinued | $0.48 | $0.49 | $0.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.36 Median $0.37 Typical High $0.47 | Professional | 55 · Aftercare only | $0.36 | $0.37 | $0.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.24 Median $0.25 Typical High $0.31 | Professional | 56 · Pre-op care only | $0.24 | $0.25 | $0.31 |
Where Georgia sits
The same service costs 2.2 times more in Kansas 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
$3.24
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.