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 $10.00 Median $10.00 Typical High $13.18 | Facility | None | $10.00 | $10.00 | $13.18 |
Aetna Setting Professional Modifier None Typical Low $9.77 Median $10.00 Typical High $12.59 | Professional | None | $9.77 | $10.00 | $12.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.13 Median $14.13 Typical High $74.13 | Professional | None | $8.13 | $14.13 | $74.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.79 Median $1.62 Typical High $7.41 | Professional | RR · Rental | $0.79 | $1.62 | $7.41 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $5.89 Median $12.02 Typical High $54.95 | Professional | UE · Used equipment | $5.89 | $12.02 | $54.95 |
CareSource Setting Facility Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Facility | None | $13.49 | $13.49 | $13.49 |
CareSource Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | None | $13.49 | $13.49 | $13.49 |
Cigna Setting Facility Modifier None Typical Low $8.13 Median $9.55 Typical High $9.55 | Facility | None | $8.13 | $9.55 | $9.55 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $21.38 | Professional | None | $8.13 | $8.13 | $21.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $11.22 Median $16.22 Typical High $21.38 | Professional | None | $11.22 | $16.22 | $21.38 |
United Setting Professional Modifier None Typical Low $5.25 Median $7.94 Typical High $18.62 | Professional | None | $5.25 | $7.94 | $18.62 |
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 $1.45 Median $1.51 Typical High $1.91 | Professional | 55 · Aftercare only | $1.45 | $1.51 | $1.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.98 Median $1.00 Typical High $1.26 | Professional | 56 · Pre-op care only | $0.98 | $1.00 | $1.26 |
Where Georgia sits
The same service costs 2.2 times more in Kansas 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
$13.18
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.