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 $27.54 Median $27.54 Typical High $36.31 | Facility | None | $27.54 | $27.54 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $26.92 Median $28.18 Typical High $72.44 | Professional | None | $26.92 | $28.18 | $72.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $22.91 Median $38.90 Typical High $199.53 | Professional | None | $22.91 | $38.90 | $199.53 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.09 Median $4.37 Typical High $19.95 | Professional | RR · Rental | $3.09 | $4.37 | $19.95 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $22.91 Median $33.11 Typical High $151.36 | Professional | UE · Used equipment | $22.91 | $33.11 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $58.88 | Professional | None | $21.88 | $21.88 | $58.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $52.48 | Professional | None | $43.65 | $43.65 | $52.48 |
United Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $22.91 | Professional | None | $15.14 | $15.14 | $22.91 |
5 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 $13.49 Median $13.80 Typical High $15.49 | Professional | 52 · Reduced service | $13.49 | $13.80 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $5.50 Typical High $6.17 | Professional | 53 · Discontinued | $5.37 | $5.50 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $4.07 Typical High $4.68 | Professional | 55 · Aftercare only | $3.98 | $4.07 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $2.75 Typical High $3.09 | Professional | 56 · Pre-op care only | $2.69 | $2.75 | $3.09 |
Ambetter Setting Professional Modifier A1 · Dressing, 1 wound Typical Low $41.69 Median $85.11 Typical High $85.11 | Professional | A1 · Dressing, 1 wound | $41.69 | $85.11 | $85.11 |
Where Georgia sits
The same service costs 3.2 times more in Hawaii than in Utah. 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· 13th of 51
$38.02
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.