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 $5.25 Median $5.25 Typical High $5.37 | Facility | None | $5.25 | $5.25 | $5.37 |
Aetna Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $6.61 | Professional | None | $5.25 | $5.25 | $6.61 |
Ambetter Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.37 Median $18.20 Typical High $19.50 | Facility | None | $5.37 | $18.20 | $19.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.07 Median $4.79 Typical High $15.14 | Professional | None | $4.07 | $4.79 | $15.14 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.38 Median $0.49 Typical High $2.51 | Professional | RR · Rental | $0.38 | $0.49 | $2.51 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.02 Median $3.89 Typical High $18.62 | Professional | UE · Used equipment | $3.02 | $3.89 | $18.62 |
Cigna Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | None | $2.57 | $2.57 | $2.57 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.47 Median $6.03 Typical High $11.22 | Professional | None | $4.47 | $6.03 | $11.22 |
United Setting Professional Modifier None Typical Low $2.14 Median $8.91 Typical High $13.49 | Professional | None | $2.14 | $8.91 | $13.49 |
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 $0.79 Median $0.79 Typical High $1.00 | Professional | 55 · Aftercare only | $0.79 | $0.79 | $1.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.52 Typical High $0.66 | Professional | 56 · Pre-op care only | $0.52 | $0.52 | $0.66 |
Where Georgia sits
The same service costs 4.2 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· 41st of 51
$4.90
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.