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 $2.82 Median $2.82 Typical High $3.72 | Facility | None | $2.82 | $2.82 | $3.72 |
Aetna Setting Professional Modifier None Typical Low $2.75 Median $2.82 Typical High $3.55 | Professional | None | $2.75 | $2.82 | $3.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.24 Median $3.98 Typical High $20.42 | Professional | None | $2.24 | $3.98 | $20.42 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.21 Median $0.45 Typical High $2.04 | Professional | RR · Rental | $0.21 | $0.45 | $2.04 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.58 Median $3.39 Typical High $15.49 | Professional | UE · Used equipment | $1.58 | $3.39 | $15.49 |
CareSource Setting Facility Modifier None Typical Low $3.80 Median $3.80 Typical High $3.80 | Facility | None | $3.80 | $3.80 | $3.80 |
CareSource Setting Professional Modifier None Typical Low $3.80 Median $3.80 Typical High $3.80 | Professional | None | $3.80 | $3.80 | $3.80 |
Cigna Setting Facility Modifier None Typical Low $2.69 Median $2.69 Typical High $3.31 | Facility | None | $2.69 | $2.69 | $3.31 |
Cigna Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $6.03 | Professional | None | $2.29 | $2.29 | $6.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.16 Median $4.57 Typical High $6.31 | Professional | None | $3.16 | $4.57 | $6.31 |
United Setting Professional Modifier None Typical Low $1.48 Median $2.19 Typical High $5.25 | Professional | None | $1.48 | $2.19 | $5.25 |
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 $0.41 Median $0.42 Typical High $0.52 | Professional | 55 · Aftercare only | $0.41 | $0.42 | $0.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.27 Median $0.28 Typical High $0.36 | Professional | 56 · Pre-op care only | $0.27 | $0.28 | $0.36 |
Where Georgia sits
The same service costs 2.3 times more in Hawaii than in Connecticut. 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· 15th of 51
$3.55
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.