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 $2.40 Median $2.40 Typical High $3.16 | Facility | None | $2.40 | $2.40 | $3.16 |
Aetna Setting Professional Modifier None Typical Low $2.09 Median $2.40 Typical High $3.02 | Professional | None | $2.09 | $2.40 | $3.02 |
Ambetter Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | None | $2.19 | $2.19 | $2.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.91 Median $3.31 Typical High $17.78 | Professional | None | $1.91 | $3.31 | $17.78 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.19 Median $0.39 Typical High $1.78 | Professional | RR · Rental | $0.19 | $0.39 | $1.78 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.41 Median $2.88 Typical High $13.18 | Professional | UE · Used equipment | $1.41 | $2.88 | $13.18 |
CareSource Setting Facility Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Facility | None | $3.24 | $3.24 | $3.24 |
CareSource Setting Professional Modifier None Typical Low $3.24 Median $4.90 Typical High $6.03 | Professional | None | $3.24 | $4.90 | $6.03 |
Cigna Setting Facility Modifier None Typical Low $2.29 Median $2.29 Typical High $2.40 | Facility | None | $2.29 | $2.29 | $2.40 |
Cigna Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $5.13 | Professional | None | $1.95 | $1.95 | $5.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.69 Median $3.89 Typical High $5.50 | Professional | None | $2.69 | $3.89 | $5.50 |
United Setting Professional Modifier None Typical Low $1.26 Median $1.86 Typical High $4.47 | Professional | None | $1.26 | $1.86 | $4.47 |
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 $0.35 Median $0.36 Typical High $0.45 | Professional | 55 · Aftercare only | $0.35 | $0.36 | $0.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.23 Median $0.24 Typical High $0.30 | Professional | 56 · Pre-op care only | $0.23 | $0.24 | $0.30 |
Where Georgia sits
The same service costs 2.1 times more in Idaho than in New Jersey. 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· 19th of 51
$2.82
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.