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 $4.57 Median $4.57 Typical High $7.41 | Facility | None | $4.57 | $4.57 | $7.41 |
Aetna Setting Professional Modifier None Typical Low $4.57 Median $4.90 Typical High $6.92 | Professional | None | $4.57 | $4.90 | $6.92 |
Ambetter Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $11.22 Median $38.90 Typical High $41.69 | Facility | None | $11.22 | $38.90 | $41.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.17 Median $9.77 Typical High $69.18 | Professional | None | $6.17 | $9.77 | $69.18 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.68 Median $1.51 Typical High $6.92 | Professional | RR · Rental | $0.68 | $1.51 | $6.92 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $5.01 Median $10.00 Typical High $51.29 | Professional | UE · Used equipment | $5.01 | $10.00 | $51.29 |
CareSource Setting Facility Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Facility | None | $9.33 | $9.33 | $9.33 |
CareSource Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | None | $9.33 | $9.33 | $9.33 |
Cigna Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Facility | None | $7.08 | $7.08 | $7.08 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $15.14 | Professional | None | $5.25 | $5.25 | $15.14 |
Kaiser Permanente Setting Professional Modifier None Typical Low $7.94 Median $11.22 Typical High $15.85 | Professional | None | $7.94 | $11.22 | $15.85 |
United Setting Facility Modifier None Typical Low $6.31 Median $6.31 Typical High $7.94 | Facility | None | $6.31 | $6.31 | $7.94 |
United Setting Professional Modifier None Typical Low $4.37 Median $5.50 Typical High $14.13 | Professional | None | $4.37 | $5.50 | $14.13 |
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 $2.29 Median $2.45 Typical High $3.47 | Professional | 52 · Reduced service | $2.29 | $2.45 | $3.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.91 Median $1.00 Typical High $1.41 | Professional | 53 · Discontinued | $0.91 | $1.00 | $1.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.69 Median $0.74 Typical High $1.05 | Professional | 55 · Aftercare only | $0.69 | $0.74 | $1.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.46 Median $0.49 Typical High $0.71 | Professional | 56 · Pre-op care only | $0.46 | $0.49 | $0.71 |
Where Georgia sits
The same service costs 3.5 times more in Montana than in Kansas. 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
$9.12
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.