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 $5.75 Median $5.75 Typical High $7.59 | Facility | None | $5.75 | $5.75 | $7.59 |
Aetna Setting Professional Modifier None Typical Low $5.62 Median $5.75 Typical High $7.24 | Professional | None | $5.62 | $5.75 | $7.24 |
Ambetter Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | None | $5.25 | $5.25 | $5.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.79 Median $8.13 Typical High $42.66 | Professional | None | $4.79 | $8.13 | $42.66 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.46 Median $0.93 Typical High $4.27 | Professional | RR · Rental | $0.46 | $0.93 | $4.27 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.39 Median $6.46 Typical High $31.62 | Professional | UE · Used equipment | $3.39 | $6.46 | $31.62 |
CareSource Setting Facility Modifier None Typical Low $7.76 Median $7.76 Typical High $7.76 | Facility | None | $7.76 | $7.76 | $7.76 |
CareSource Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $7.76 | Professional | None | $7.76 | $7.76 | $7.76 |
Cigna Setting Facility Modifier None Typical Low $5.50 Median $5.50 Typical High $5.75 | Facility | None | $5.50 | $5.50 | $5.75 |
Cigna Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $12.59 | Professional | None | $4.68 | $4.68 | $12.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $6.46 Median $9.33 Typical High $3,467.37 | Professional | None | $6.46 | $9.33 | $3,467.37 |
United Setting Professional Modifier None Typical Low $3.02 Median $4.57 Typical High $10.72 | Professional | None | $3.02 | $4.57 | $10.72 |
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 $2.82 Median $2.88 Typical High $3.63 | Professional | 52 · Reduced service | $2.82 | $2.88 | $3.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.12 Median $1.15 Typical High $1.45 | Professional | 53 · Discontinued | $1.12 | $1.15 | $1.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.83 Median $0.87 Typical High $1.10 | Professional | 55 · Aftercare only | $0.83 | $0.87 | $1.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.56 Median $0.58 Typical High $0.72 | Professional | 56 · Pre-op care only | $0.56 | $0.58 | $0.72 |
Where Georgia sits
The same service costs 2.3 times more in Kansas than in Alabama. 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· 12th of 51
$7.94
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.