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 $3.16 Median $3.16 Typical High $4.17 | Facility | None | $3.16 | $3.16 | $4.17 |
Aetna Setting Professional Modifier None Typical Low $3.09 Median $3.16 Typical High $3.98 | Professional | None | $3.09 | $3.16 | $3.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.69 Median $4.47 Typical High $23.44 | Professional | None | $2.69 | $4.47 | $23.44 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.33 Median $0.51 Typical High $2.29 | Professional | RR · Rental | $0.33 | $0.51 | $2.29 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.45 Median $3.80 Typical High $17.38 | Professional | UE · Used equipment | $2.45 | $3.80 | $17.38 |
CareSource Setting Facility Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Facility | None | $4.27 | $4.27 | $4.27 |
CareSource Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
Cigna Setting Facility Modifier None Typical Low $3.02 Median $3.02 Typical High $3.72 | Facility | None | $3.02 | $3.02 | $3.72 |
Cigna Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $6.76 | Professional | None | $2.57 | $2.57 | $6.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.55 Median $5.13 Typical High $7.41 | Professional | None | $3.55 | $5.13 | $7.41 |
United Setting Professional Modifier None Typical Low $1.66 Median $2.51 Typical High $6.92 | Professional | None | $1.66 | $2.51 | $6.92 |
2 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 55 · Aftercare only Typical Low $0.46 Median $0.48 Typical High $0.60 | Professional | 55 · Aftercare only | $0.46 | $0.48 | $0.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.31 Median $0.32 Typical High $0.40 | Professional | 56 · Pre-op care only | $0.31 | $0.32 | $0.40 |
Where Georgia sits
The same service costs 2.2 times more in Kansas than in Delaware. 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
$4.17
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.