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 $3.98 Median $3.98 Typical High $3.98 | Facility | None | $3.98 | $3.98 | $3.98 |
Aetna Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | None | $3.98 | $3.98 | $3.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.54 Median $0.68 Typical High $0.68 | Professional | None | $0.54 | $0.68 | $0.68 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.50 Median $0.50 Typical High $0.68 | Professional | UE · Used equipment | $0.50 | $0.50 | $0.68 |
Cigna Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $2.29 | Professional | None | $2.29 | $2.29 | $2.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | None | $19.05 | $19.05 | $19.05 |
3 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 $0.60 Median $0.60 Typical High $0.60 | Professional | 55 · Aftercare only | $0.60 | $0.60 | $0.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.40 Median $0.40 Typical High $0.40 | Professional | 56 · Pre-op care only | $0.40 | $0.40 | $0.40 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.09 Median $0.09 Typical High $0.11 | Professional | RR · Rental | $0.09 | $0.09 | $0.11 |
Where Georgia sits
The same service costs 117.5 times more in Montana than in Georgia. 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· 51st of 51
$0.68
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.