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 $8.51 Median $8.51 Typical High $11.22 | Facility | None | $8.51 | $8.51 | $11.22 |
Aetna Setting Professional Modifier None Typical Low $8.32 Median $8.51 Typical High $10.72 | Professional | None | $8.32 | $8.51 | $10.72 |
Ambetter Setting Professional Modifier None Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | None | $8.91 | $8.91 | $8.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.92 Median $12.02 Typical High $63.10 | Professional | None | $6.92 | $12.02 | $63.10 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.66 Median $1.35 Typical High $6.31 | Professional | RR · Rental | $0.66 | $1.35 | $6.31 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.90 Median $10.23 Typical High $46.77 | Professional | UE · Used equipment | $4.90 | $10.23 | $46.77 |
CareSource Setting Facility Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Facility | None | $11.48 | $11.48 | $11.48 |
CareSource Setting Professional Modifier None Typical Low $11.48 Median $17.38 Typical High $21.38 | Professional | None | $11.48 | $17.38 | $21.38 |
Cigna Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $8.51 | Facility | None | $8.13 | $8.13 | $8.51 |
Cigna Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $18.20 | Professional | None | $6.92 | $6.92 | $18.20 |
Kaiser Permanente Setting Professional Modifier None Typical Low $9.55 Median $13.80 Typical High $19.05 | Professional | None | $9.55 | $13.80 | $19.05 |
United Setting Professional Modifier None Typical Low $4.47 Median $6.76 Typical High $15.85 | Professional | None | $4.47 | $6.76 | $15.85 |
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 $4.17 Median $4.27 Typical High $5.37 | Professional | 52 · Reduced service | $4.17 | $4.27 | $5.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.66 Median $1.70 Typical High $2.14 | Professional | 53 · Discontinued | $1.66 | $1.70 | $2.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $1.29 Typical High $1.62 | Professional | 55 · Aftercare only | $1.23 | $1.29 | $1.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.83 Median $0.85 Typical High $1.07 | Professional | 56 · Pre-op care only | $0.83 | $0.85 | $1.07 |
Where Georgia sits
The same service costs 2.2 times more in Hawaii than in Maine. 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
$11.75
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.