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 $1.26 Median $1.26 Typical High $1.66 | Facility | None | $1.26 | $1.26 | $1.66 |
Aetna Setting Professional Modifier None Typical Low $1.23 Median $1.26 Typical High $1.41 | Professional | None | $1.23 | $1.26 | $1.41 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.05 Median $1.78 Typical High $9.33 | Professional | None | $1.05 | $1.78 | $9.33 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.15 Median $0.20 Typical High $0.91 | Professional | RR · Rental | $0.15 | $0.20 | $0.91 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.07 Median $1.51 Typical High $6.92 | Professional | UE · Used equipment | $1.07 | $1.51 | $6.92 |
Cigna Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $2.69 | Professional | None | $1.02 | $1.02 | $2.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.04 Median $2.04 Typical High $2.45 | Professional | None | $2.04 | $2.04 | $2.45 |
United Setting Professional Modifier None Typical Low $0.66 Median $1.00 Typical High $3.80 | Professional | None | $0.66 | $1.00 | $3.80 |
2 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 55 · Aftercare only Typical Low $0.18 Median $0.19 Typical High $0.21 | Professional | 55 · Aftercare only | $0.18 | $0.19 | $0.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.12 Median $0.13 Typical High $0.14 | Professional | 56 · Pre-op care only | $0.12 | $0.13 | $0.14 |
Where Georgia sits
The same service costs 3.1 times more in Hawaii than in Utah. 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
$1.78
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.