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 $0.38 Median $0.38 Typical High $0.39 | Facility | None | $0.38 | $0.38 | $0.39 |
Aetna Setting Professional Modifier None Typical Low $0.38 Median $0.38 Typical High $0.47 | Professional | None | $0.38 | $0.38 | $0.47 |
Ambetter Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.39 Median $1.35 Typical High $1.45 | Facility | None | $0.39 | $1.35 | $1.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.34 Median $0.40 Typical High $1.82 | Professional | None | $0.34 | $0.40 | $1.82 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.23 Median $0.30 Typical High $0.72 | Professional | UE · Used equipment | $0.23 | $0.30 | $0.72 |
Cigna Setting Professional Modifier None Typical Low $0.24 Median $0.24 Typical High $0.24 | Professional | None | $0.24 | $0.24 | $0.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.33 Median $0.44 Typical High $1.12 | Professional | None | $0.33 | $0.44 | $1.12 |
United Setting Professional Modifier None Typical Low $0.15 Median $0.63 Typical High $0.93 | Professional | None | $0.15 | $0.63 | $0.93 |
3 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 $0.06 Median $0.06 Typical High $0.07 | Professional | 55 · Aftercare only | $0.06 | $0.06 | $0.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.05 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.04 Median $0.04 Typical High $0.18 | Professional | RR · Rental | $0.04 | $0.04 | $0.18 |
Where Georgia sits
The same service costs 3.1 times more in Florida than in Alabama. 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· 26th of 51
$0.40
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.