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 $7.24 Median $7.24 Typical High $9.55 | Facility | None | $7.24 | $7.24 | $9.55 |
Aetna Setting Professional Modifier None Typical Low $7.08 Median $7.24 Typical High $9.12 | Professional | None | $7.08 | $7.24 | $9.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.75 Median $10.23 Typical High $33.88 | Professional | None | $5.75 | $10.23 | $33.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.58 Median $1.17 Typical High $5.37 | Professional | RR · Rental | $0.58 | $1.17 | $5.37 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.37 Median $8.91 Typical High $39.81 | Professional | UE · Used equipment | $4.37 | $8.91 | $39.81 |
CareSource Setting Facility Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Facility | None | $9.77 | $9.77 | $9.77 |
CareSource Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
Cigna Setting Facility Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Facility | None | $7.59 | $7.59 | $7.59 |
Cigna Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $15.85 | Professional | None | $6.46 | $6.46 | $15.85 |
Kaiser Permanente Setting Professional Modifier None Typical Low $8.32 Median $11.75 Typical High $3,630.78 | Professional | None | $8.32 | $11.75 | $3,630.78 |
United Setting Professional Modifier None Typical Low $3.80 Median $5.75 Typical High $13.49 | Professional | None | $3.80 | $5.75 | $13.49 |
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 $3.55 Median $3.63 Typical High $4.57 | Professional | 52 · Reduced service | $3.55 | $3.63 | $4.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.41 Median $1.45 Typical High $1.82 | Professional | 53 · Discontinued | $1.41 | $1.45 | $1.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.07 Median $1.10 Typical High $1.38 | Professional | 55 · Aftercare only | $1.07 | $1.10 | $1.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.71 Median $0.72 Typical High $0.91 | Professional | 56 · Pre-op care only | $0.71 | $0.72 | $0.91 |
Where Georgia sits
The same service costs 2.1 times more in Idaho 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
$9.55
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.