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 $0.55 Median $0.55 Typical High $0.62 | Facility | None | $0.55 | $0.55 | $0.62 |
Aetna Setting Professional Modifier None Typical Low $0.54 Median $0.55 Typical High $0.63 | Professional | None | $0.54 | $0.55 | $0.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.62 Median $0.98 Typical High $4.07 | Professional | None | $0.62 | $0.98 | $4.07 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.06 Median $0.09 Typical High $0.41 | Professional | RR · Rental | $0.06 | $0.09 | $0.41 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.47 Median $0.72 Typical High $3.09 | Professional | UE · Used equipment | $0.47 | $0.72 | $3.09 |
Cigna Setting Professional Modifier None Typical Low $0.45 Median $0.45 Typical High $1.20 | Professional | None | $0.45 | $0.45 | $1.20 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $1.10 | Professional | None | $0.89 | $0.89 | $1.10 |
Oscar Health Setting Professional Modifier None Typical Low $1.05 Median $1.05 Typical High $1.20 | Professional | None | $1.05 | $1.05 | $1.20 |
United Setting Professional Modifier None Typical Low $0.28 Median $0.44 Typical High $1.66 | Professional | None | $0.28 | $0.44 | $1.66 |
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 $0.27 Median $0.28 Typical High $0.32 | Professional | 52 · Reduced service | $0.27 | $0.28 | $0.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.11 Median $0.11 Typical High $0.13 | Professional | 53 · Discontinued | $0.11 | $0.11 | $0.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.08 Median $0.08 Typical High $0.09 | Professional | 55 · Aftercare only | $0.08 | $0.08 | $0.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.06 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.05 | $0.06 | $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· 13th of 51
$0.72
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.