How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $4.27 Median $4.27 Typical High $4.27 | Facility | None | $4.27 | $4.27 | $4.27 |
Aetna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $17.38 Median $26.30 Typical High $125.89 | Professional | None | $17.38 | $26.30 | $125.89 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.74 Median $2.51 Typical High $12.30 | Professional | RR · Rental | $1.74 | $2.51 | $12.30 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $12.88 Median $19.05 Typical High $93.33 | Professional | UE · Used equipment | $12.88 | $19.05 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $33.88 | Professional | None | $13.49 | $13.49 | $33.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $15.85 Median $25.12 Typical High $30.20 | Professional | None | $15.85 | $25.12 | $30.20 |
United Setting Professional Modifier None Typical Low $8.71 Median $12.88 Typical High $44.67 | Professional | None | $8.71 | $12.88 | $44.67 |
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 $2.14 Median $2.14 Typical High $2.14 | Professional | 52 · Reduced service | $2.14 | $2.14 | $2.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.85 Median $0.85 Typical High $0.85 | Professional | 53 · Discontinued | $0.85 | $0.85 | $0.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.65 Median $0.65 Typical High $0.65 | Professional | 55 · Aftercare only | $0.65 | $0.65 | $0.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.43 Median $0.43 Typical High $0.43 | Professional | 56 · Pre-op care only | $0.43 | $0.43 | $0.43 |
Where Georgia sits
The same service costs 6.9 times more in Montana than in Indiana. 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· 9th of 51
$21.38
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.