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 $1.55 Median $1.55 Typical High $2.04 | Facility | None | $1.55 | $1.55 | $2.04 |
Aetna Setting Professional Modifier None Typical Low $1.51 Median $1.55 Typical High $1.95 | Professional | None | $1.51 | $1.55 | $1.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.74 Median $2.24 Typical High $11.48 | Professional | None | $1.74 | $2.24 | $11.48 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.18 Median $0.22 Typical High $1.12 | Professional | RR · Rental | $0.18 | $0.22 | $1.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.35 Median $1.86 Typical High $8.51 | Professional | UE · Used equipment | $1.35 | $1.86 | $8.51 |
Cigna Setting Professional Modifier None Typical Low $1.02 Median $1.12 Typical High $3.02 | Professional | None | $1.02 | $1.12 | $3.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $10.96 | Professional | None | $2.51 | $2.51 | $10.96 |
Oscar Health Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $3.31 | Professional | None | $2.88 | $2.88 | $3.31 |
United Setting Professional Modifier None Typical Low $0.81 Median $1.23 Typical High $4.68 | Professional | None | $0.81 | $1.23 | $4.68 |
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 $0.76 Median $0.78 Typical High $0.98 | Professional | 52 · Reduced service | $0.76 | $0.78 | $0.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.30 Median $0.31 Typical High $0.39 | Professional | 53 · Discontinued | $0.30 | $0.31 | $0.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.23 Median $0.23 Typical High $0.28 | Professional | 55 · Aftercare only | $0.23 | $0.23 | $0.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.15 Median $0.16 Typical High $0.20 | Professional | 56 · Pre-op care only | $0.15 | $0.16 | $0.20 |
Where Georgia sits
The same service costs 4.6 times more in Rhode Island 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· 12th of 51
$2.24
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.