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 $1.12 Median $1.12 Typical High $1.26 | Facility | None | $1.12 | $1.12 | $1.26 |
Aetna Setting Professional Modifier None Typical Low $1.10 Median $1.12 Typical High $1.35 | Professional | None | $1.10 | $1.12 | $1.35 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.26 Median $1.62 Typical High $8.13 | Professional | None | $1.26 | $1.62 | $8.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.13 Median $0.18 Typical High $0.81 | Professional | RR · Rental | $0.13 | $0.18 | $0.81 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.93 Median $1.35 Typical High $6.17 | Professional | UE · Used equipment | $0.93 | $1.35 | $6.17 |
Cigna Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $2.40 | Professional | None | $0.89 | $0.89 | $2.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $2.24 | Professional | None | $1.78 | $1.78 | $2.24 |
Oscar Health Setting Professional Modifier None Typical Low $2.04 Median $2.04 Typical High $2.34 | Professional | None | $2.04 | $2.04 | $2.34 |
United Setting Professional Modifier None Typical Low $0.59 Median $0.87 Typical High $3.31 | Professional | None | $0.59 | $0.87 | $3.31 |
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 $0.55 Median $0.56 Typical High $0.63 | Professional | 52 · Reduced service | $0.55 | $0.56 | $0.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.22 Median $0.22 Typical High $0.25 | Professional | 53 · Discontinued | $0.22 | $0.22 | $0.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.16 Median $0.17 Typical High $0.19 | Professional | 55 · Aftercare only | $0.16 | $0.17 | $0.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.11 Typical High $0.13 | Professional | 56 · Pre-op care only | $0.11 | $0.11 | $0.13 |
Where Georgia sits
The same service costs 2.5 times more in Idaho 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
$1.58
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.