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 $2.63 Median $2.63 Typical High $4.27 | Facility | None | $2.63 | $2.63 | $4.27 |
Aetna Setting Professional Modifier None Typical Low $2.63 Median $2.75 Typical High $3.98 | Professional | None | $2.63 | $2.75 | $3.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $6.46 Median $22.39 Typical High $23.99 | Facility | None | $6.46 | $22.39 | $23.99 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.55 Median $5.62 Typical High $34.67 | Professional | None | $3.55 | $5.62 | $34.67 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.34 Median $0.76 Typical High $3.47 | Professional | RR · Rental | $0.34 | $0.76 | $3.47 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.57 Median $5.25 Typical High $26.30 | Professional | UE · Used equipment | $2.57 | $5.25 | $26.30 |
CareSource Setting Facility Modifier None Typical Low $5.37 Median $5.37 Typical High $5.37 | Facility | None | $5.37 | $5.37 | $5.37 |
CareSource Setting Professional Modifier None Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | None | $5.37 | $5.37 | $5.37 |
Cigna Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Facility | None | $3.55 | $3.55 | $3.55 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $8.71 | Professional | None | $2.95 | $2.95 | $8.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.57 Median $6.46 Typical High $10.96 | Professional | None | $4.57 | $6.46 | $10.96 |
United Setting Professional Modifier None Typical Low $2.19 Median $3.16 Typical High $8.13 | Professional | None | $2.19 | $3.16 | $8.13 |
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 $1.32 Median $1.38 Typical High $2.00 | Professional | 52 · Reduced service | $1.32 | $1.38 | $2.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.52 Median $0.56 Typical High $0.79 | Professional | 53 · Discontinued | $0.52 | $0.56 | $0.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.40 Median $0.42 Typical High $0.60 | Professional | 55 · Aftercare only | $0.40 | $0.42 | $0.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.26 Median $0.28 Typical High $0.40 | Professional | 56 · Pre-op care only | $0.26 | $0.28 | $0.40 |
Where Georgia sits
The same service costs 4.9 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· 14th of 51
$5.25
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.