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 $0.49 Median $0.49 Typical High $0.65 | Facility | None | $0.49 | $0.49 | $0.65 |
Aetna Setting Professional Modifier None Typical Low $0.48 Median $0.49 Typical High $0.56 | Professional | None | $0.48 | $0.49 | $0.56 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.55 Median $0.72 Typical High $3.63 | Professional | None | $0.55 | $0.72 | $3.63 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.06 Median $0.08 Typical High $0.36 | Professional | RR · Rental | $0.06 | $0.08 | $0.36 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.41 Median $0.60 Typical High $2.75 | Professional | UE · Used equipment | $0.41 | $0.60 | $2.75 |
Cigna Setting Professional Modifier None Typical Low $0.40 Median $0.40 Typical High $1.07 | Professional | None | $0.40 | $0.40 | $1.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $1.12 | Professional | None | $0.79 | $0.79 | $1.12 |
Oscar Health Setting Professional Modifier None Typical Low $0.91 Median $0.91 Typical High $1.05 | Professional | None | $0.91 | $0.91 | $1.05 |
United Setting Professional Modifier None Typical Low $0.26 Median $0.39 Typical High $1.48 | Professional | None | $0.26 | $0.39 | $1.48 |
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 $0.24 Median $0.25 Typical High $0.28 | Professional | 52 · Reduced service | $0.24 | $0.25 | $0.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.10 Median $0.10 Typical High $0.11 | Professional | 53 · Discontinued | $0.10 | $0.10 | $0.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.07 Median $0.07 Typical High $0.09 | Professional | 55 · Aftercare only | $0.07 | $0.07 | $0.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.05 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.05 | $0.05 | $0.06 |
Where Georgia sits
The same service costs 2.6 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· 11th of 51
$0.69
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.