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 $1.66 Median $1.66 Typical High $1.66 | Facility | None | $1.66 | $1.66 | $1.66 |
Aetna Setting Professional Modifier None Typical Low $1.62 Median $1.66 Typical High $1.86 | Professional | None | $1.62 | $1.66 | $1.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.58 Median $2.29 Typical High $12.02 | Professional | None | $1.58 | $2.29 | $12.02 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.19 Median $0.27 Typical High $1.23 | Professional | RR · Rental | $0.19 | $0.27 | $1.23 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.38 Median $2.00 Typical High $9.12 | Professional | UE · Used equipment | $1.38 | $2.00 | $9.12 |
Cigna Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $3.55 | Professional | None | $1.32 | $1.32 | $3.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.63 Median $2.63 Typical High $3.39 | Professional | None | $2.63 | $2.63 | $3.39 |
Oscar Health Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $3.55 | Professional | None | $3.09 | $3.09 | $3.55 |
United Setting Professional Modifier None Typical Low $0.87 Median $1.32 Typical High $4.90 | Professional | None | $0.87 | $1.32 | $4.90 |
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 $0.81 Median $0.83 Typical High $0.93 | Professional | 52 · Reduced service | $0.81 | $0.83 | $0.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.32 Median $0.33 Typical High $0.38 | Professional | 53 · Discontinued | $0.32 | $0.33 | $0.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.24 Median $0.25 Typical High $0.28 | Professional | 55 · Aftercare only | $0.24 | $0.25 | $0.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.16 Median $0.17 Typical High $0.19 | Professional | 56 · Pre-op care only | $0.16 | $0.17 | $0.19 |
Where Georgia sits
The same service costs 2.6 times more in Hawaii than in Colorado. 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
$2.29
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.