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 $0.62 Median $0.62 Typical High $0.79 | Facility | None | $0.62 | $0.62 | $0.79 |
Aetna Setting Professional Modifier None Typical Low $0.59 Median $0.62 Typical High $0.68 | Professional | None | $0.59 | $0.62 | $0.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.49 Median $0.87 Typical High $4.47 | Professional | None | $0.49 | $0.87 | $4.47 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.07 Median $0.10 Typical High $0.45 | Professional | RR · Rental | $0.07 | $0.10 | $0.45 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.49 Median $0.72 Typical High $3.31 | Professional | UE · Used equipment | $0.49 | $0.72 | $3.31 |
Cigna Setting Professional Modifier None Typical Low $0.49 Median $0.49 Typical High $1.29 | Professional | None | $0.49 | $0.49 | $1.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.98 Median $0.98 Typical High $1.15 | Professional | None | $0.98 | $0.98 | $1.15 |
Oscar Health Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.29 | Professional | None | $1.12 | $1.12 | $1.29 |
United Setting Professional Modifier None Typical Low $0.32 Median $0.48 Typical High $1.82 | Professional | None | $0.32 | $0.48 | $1.82 |
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 $0.30 Median $0.31 Typical High $0.34 | Professional | 52 · Reduced service | $0.30 | $0.31 | $0.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.12 Median $0.12 Typical High $0.14 | Professional | 53 · Discontinued | $0.12 | $0.12 | $0.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.09 Median $0.09 Typical High $0.10 | Professional | 55 · Aftercare only | $0.09 | $0.09 | $0.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.07 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.07 |
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· 11th of 51
$0.85
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.