How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $28.18 Median $28.18 Typical High $37.15 | Facility | None | $28.18 | $28.18 | $37.15 |
Aetna Setting Professional Modifier None Typical Low $27.54 Median $28.18 Typical High $37.15 | Professional | None | $27.54 | $28.18 | $37.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.90 Median $42.66 Typical High $204.17 | Professional | None | $30.90 | $42.66 | $204.17 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.24 Median $4.47 Typical High $20.42 | Professional | RR · Rental | $3.24 | $4.47 | $20.42 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $25.12 Median $33.88 Typical High $154.88 | Professional | UE · Used equipment | $25.12 | $33.88 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $60.26 | Professional | None | $18.20 | $18.20 | $60.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $169.82 | Professional | None | $44.67 | $44.67 | $169.82 |
Oscar Health Setting Professional Modifier None Typical Low $51.29 Median $58.88 Typical High $63.10 | Professional | None | $51.29 | $58.88 | $63.10 |
United Setting Professional Modifier None Typical Low $14.45 Median $21.88 Typical High $79.43 | Professional | None | $14.45 | $21.88 | $79.43 |
5 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 $13.49 Median $14.13 Typical High $15.85 | Professional | 52 · Reduced service | $13.49 | $14.13 | $15.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $5.62 Typical High $6.31 | Professional | 53 · Discontinued | $5.50 | $5.62 | $6.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $20.42 Median $20.89 Typical High $23.99 | Professional | 54 · Surgery only | $20.42 | $20.89 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $4.17 Typical High $4.79 | Professional | 55 · Aftercare only | $4.07 | $4.17 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $2.82 Typical High $3.16 | Professional | 56 · Pre-op care only | $2.75 | $2.82 | $3.16 |
Where Georgia sits
The same service costs 2.7 times more in Hawaii than in New York. 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· 11th of 51
$39.81
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.