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 $0.69 Median $0.69 Typical High $0.91 | Facility | None | $0.69 | $0.69 | $0.91 |
Aetna Setting Professional Modifier None Typical Low $0.68 Median $0.69 Typical High $0.79 | Professional | None | $0.68 | $0.69 | $0.79 |
Ambetter Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $95.50 | Professional | None | $70.79 | $70.79 | $95.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.78 Median $1.00 Typical High $5.13 | Professional | None | $0.78 | $1.00 | $5.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.08 Median $0.11 Typical High $0.50 | Professional | RR · Rental | $0.08 | $0.11 | $0.50 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.58 Median $0.83 Typical High $3.80 | Professional | UE · Used equipment | $0.58 | $0.83 | $3.80 |
Cigna Setting Professional Modifier None Typical Low $0.55 Median $0.55 Typical High $1.51 | Professional | None | $0.55 | $0.55 | $1.51 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.10 Median $1.12 Typical High $1.35 | Professional | None | $1.10 | $1.12 | $1.35 |
Oscar Health Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.48 | Professional | None | $1.29 | $1.29 | $1.48 |
United Setting Professional Modifier None Typical Low $0.36 Median $0.55 Typical High $2.09 | Professional | None | $0.36 | $0.55 | $2.09 |
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 $0.34 Median $0.35 Typical High $0.40 | Professional | 52 · Reduced service | $0.34 | $0.35 | $0.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.13 Median $0.14 Typical High $0.16 | Professional | 53 · Discontinued | $0.13 | $0.14 | $0.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.10 Median $0.10 Typical High $0.12 | Professional | 55 · Aftercare only | $0.10 | $0.10 | $0.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.07 Median $0.07 Typical High $0.08 | Professional | 56 · Pre-op care only | $0.07 | $0.07 | $0.08 |
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
$0.98
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.