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 $10.23 Median $10.23 Typical High $13.49 | Facility | None | $10.23 | $10.23 | $13.49 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $10.23 Typical High $13.49 | Professional | None | $10.00 | $10.23 | $13.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.59 Median $16.60 Typical High $75.86 | Professional | None | $12.59 | $16.60 | $75.86 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.17 Median $1.66 Typical High $7.59 | Professional | RR · Rental | $1.17 | $1.66 | $7.59 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $9.33 Median $12.30 Typical High $56.23 | Professional | UE · Used equipment | $9.33 | $12.30 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $21.88 | Professional | None | $6.76 | $6.76 | $21.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $93.33 | Professional | None | $16.60 | $16.60 | $93.33 |
Oscar Health Setting Professional Modifier None Typical Low $18.62 Median $21.88 Typical High $22.91 | Professional | None | $18.62 | $21.88 | $22.91 |
United Setting Professional Modifier None Typical Low $5.37 Median $8.13 Typical High $30.90 | Professional | None | $5.37 | $8.13 | $30.90 |
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 $5.01 Median $5.13 Typical High $6.03 | Professional | 52 · Reduced service | $5.01 | $5.13 | $6.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.00 Median $2.04 Typical High $2.40 | Professional | 53 · Discontinued | $2.00 | $2.04 | $2.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $7.59 Median $7.76 Typical High $8.91 | Professional | 54 · Surgery only | $7.59 | $7.76 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $1.55 Typical High $1.78 | Professional | 55 · Aftercare only | $1.51 | $1.55 | $1.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $1.02 Typical High $1.20 | Professional | 56 · Pre-op care only | $1.00 | $1.02 | $1.20 |
Where Georgia sits
The same service costs 3.2 times more in Rhode Island 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· 10th of 51
$15.49
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.