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 $23.44 Median $23.44 Typical High $30.90 | Facility | None | $23.44 | $23.44 | $30.90 |
Aetna Setting Professional Modifier None Typical Low $23.44 Median $25.12 Typical High $61.66 | Professional | None | $23.44 | $25.12 | $61.66 |
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 Professional Modifier None Typical Low $28.18 Median $37.15 Typical High $169.82 | Professional | None | $28.18 | $37.15 | $169.82 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.69 Median $3.72 Typical High $16.98 | Professional | RR · Rental | $2.69 | $3.72 | $16.98 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $20.89 Median $28.18 Typical High $125.89 | Professional | UE · Used equipment | $20.89 | $28.18 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $50.12 | Professional | None | $15.14 | $15.14 | $50.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $165.96 | Professional | None | $37.15 | $37.15 | $165.96 |
Oscar Health Setting Professional Modifier None Typical Low $42.66 Median $48.98 Typical High $52.48 | Professional | None | $42.66 | $48.98 | $52.48 |
United Setting Professional Modifier None Typical Low $12.02 Median $18.20 Typical High $66.07 | Professional | None | $12.02 | $18.20 | $66.07 |
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 $11.22 Median $11.75 Typical High $13.49 | Professional | 52 · Reduced service | $11.22 | $11.75 | $13.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.57 Median $4.68 Typical High $5.37 | Professional | 53 · Discontinued | $4.57 | $4.68 | $5.37 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $16.98 Median $17.38 Typical High $20.42 | Professional | 54 · Surgery only | $16.98 | $17.38 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.39 Median $3.47 Typical High $4.07 | Professional | 55 · Aftercare only | $3.39 | $3.47 | $4.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.24 Median $2.34 Typical High $2.69 | Professional | 56 · Pre-op care only | $2.24 | $2.34 | $2.69 |
Where Georgia sits
The same service costs 3.1 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· 14th of 51
$33.11
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.