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 $1.23 Median $1.23 Typical High $1.38 | Facility | None | $1.23 | $1.23 | $1.38 |
Aetna Setting Professional Modifier None Typical Low $1.20 Median $1.23 Typical High $1.41 | Professional | None | $1.20 | $1.23 | $1.41 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.26 Median $2.00 Typical High $9.12 | Professional | None | $1.26 | $2.00 | $9.12 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.14 Median $0.20 Typical High $0.91 | Professional | RR · Rental | $0.14 | $0.20 | $0.91 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.98 Median $1.48 Typical High $6.76 | Professional | UE · Used equipment | $0.98 | $1.48 | $6.76 |
Cigna Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $2.63 | Professional | None | $1.00 | $1.00 | $2.63 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.40 | Professional | None | $2.00 | $2.00 | $2.40 |
Oscar Health Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $2.63 | Professional | None | $2.29 | $2.29 | $2.63 |
United Setting Professional Modifier None Typical Low $0.65 Median $0.98 Typical High $3.72 | Professional | None | $0.65 | $0.98 | $3.72 |
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 $0.60 Median $0.62 Typical High $0.71 | Professional | 52 · Reduced service | $0.60 | $0.62 | $0.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.24 Median $0.25 Typical High $0.28 | Professional | 53 · Discontinued | $0.24 | $0.25 | $0.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.18 Median $0.18 Typical High $0.21 | Professional | 55 · Aftercare only | $0.18 | $0.18 | $0.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.12 Median $0.12 Typical High $0.14 | Professional | 56 · Pre-op care only | $0.12 | $0.12 | $0.14 |
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
$1.74
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.