How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $3.02 Median $3.02 Typical High $3.98 | Facility | None | $3.02 | $3.02 | $3.98 |
Aetna Setting Professional Modifier None Typical Low $2.63 Median $3.02 Typical High $3.80 | Professional | None | $2.63 | $3.02 | $3.80 |
Ambetter Setting Professional Modifier None Typical Low $1.86 Median $2.45 Typical High $2.45 | Professional | None | $1.86 | $2.45 | $2.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.69 Median $4.17 Typical High $21.88 | Professional | None | $2.69 | $4.17 | $21.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.30 Median $0.48 Typical High $2.19 | Professional | RR · Rental | $0.30 | $0.48 | $2.19 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.24 Median $3.63 Typical High $16.60 | Professional | UE · Used equipment | $2.24 | $3.63 | $16.60 |
CareSource Setting Facility Modifier None Typical Low $4.07 Median $4.07 Typical High $4.07 | Facility | None | $4.07 | $4.07 | $4.07 |
CareSource Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | None | $4.07 | $4.07 | $4.07 |
Cigna Setting Facility Modifier None Typical Low $2.69 Median $2.82 Typical High $2.82 | Facility | None | $2.69 | $2.82 | $2.82 |
Cigna Setting Professional Modifier None Typical Low $2.40 Median $2.40 Typical High $6.46 | Professional | None | $2.40 | $2.40 | $6.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.39 Median $4.79 Typical High $6.46 | Professional | None | $3.39 | $4.79 | $6.46 |
United Setting Professional Modifier None Typical Low $1.58 Median $2.34 Typical High $6.61 | Professional | None | $1.58 | $2.34 | $6.61 |
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 $1.45 Median $1.51 Typical High $1.91 | Professional | 52 · Reduced service | $1.45 | $1.51 | $1.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.58 Median $0.60 Typical High $0.76 | Professional | 53 · Discontinued | $0.58 | $0.60 | $0.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.44 Median $0.45 Typical High $0.56 | Professional | 55 · Aftercare only | $0.44 | $0.45 | $0.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.30 Typical High $0.38 | Professional | 56 · Pre-op care only | $0.28 | $0.30 | $0.38 |
Where Georgia sits
The same service costs 2.2 times more in Kansas than in New Jersey. 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· 15th of 51
$3.98
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.