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 $7.41 Median $7.41 Typical High $9.12 | Facility | None | $7.41 | $7.41 | $9.12 |
Aetna Setting Professional Modifier None Typical Low $6.76 Median $8.13 Typical High $11.22 | Professional | None | $6.76 | $8.13 | $11.22 |
Ambetter Setting Professional Modifier None Typical Low $7.76 Median $15.85 Typical High $23.99 | Professional | None | $7.76 | $15.85 | $23.99 |
Anthem BCBS Setting Professional Modifier None Typical Low $9.12 Median $14.13 Typical High $19.95 | Professional | None | $9.12 | $14.13 | $19.95 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.20 Median $1.41 Typical High $1.66 | Professional | RR · Rental | $1.20 | $1.41 | $1.66 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $9.33 Median $10.72 Typical High $14.13 | Professional | UE · Used equipment | $9.33 | $10.72 | $14.13 |
CareSource Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Facility | None | $25.12 | $25.12 | $25.12 |
CareSource Setting Professional Modifier None Typical Low $10.47 Median $13.80 Typical High $16.98 | Professional | None | $10.47 | $13.80 | $16.98 |
Cigna Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $21.38 | Facility | None | $20.89 | $20.89 | $21.38 |
Cigna Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $20.89 | Professional | None | $15.49 | $15.49 | $20.89 |
Cigna Setting Professional Modifier RR · Rental Typical Low $2.09 Median $2.09 Typical High $2.09 | Professional | RR · Rental | $2.09 | $2.09 | $2.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $13.18 Median $21.88 Typical High $47.86 | Professional | None | $13.18 | $21.88 | $47.86 |
Oscar Health Setting Facility Modifier None Typical Low $4,897.79 Median $33,113.11 Typical High $33,113.11 | Facility | None | $4,897.79 | $33,113.11 | $33,113.11 |
Oscar Health Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $16.22 | Professional | None | $14.13 | $14.13 | $16.22 |
United Setting Professional Modifier None Typical Low $5.37 Median $8.32 Typical High $16.22 | Professional | None | $5.37 | $8.32 | $16.22 |
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 $3.24 Median $3.63 Typical High $4.27 | Professional | 52 · Reduced service | $3.24 | $3.63 | $4.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.35 Median $1.48 Typical High $1.74 | Professional | 53 · Discontinued | $1.35 | $1.48 | $1.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.98 Median $1.10 Typical High $1.29 | Professional | 55 · Aftercare only | $0.98 | $1.10 | $1.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.68 Median $0.72 Typical High $0.85 | Professional | 56 · Pre-op care only | $0.68 | $0.72 | $0.85 |
Where Georgia sits
The same service costs 6.2 times more in Wyoming than in North Carolina. 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· 37th of 51
$12.30
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.