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 $5.13 Median $5.13 Typical High $6.76 | Facility | None | $5.13 | $5.13 | $6.76 |
Aetna Setting Professional Modifier None Typical Low $5.01 Median $5.13 Typical High $6.46 | Professional | None | $5.01 | $5.13 | $6.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.17 Median $8.32 Typical High $38.02 | Professional | None | $6.17 | $8.32 | $38.02 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.59 Median $0.83 Typical High $3.80 | Professional | RR · Rental | $0.59 | $0.83 | $3.80 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.68 Median $6.17 Typical High $28.18 | Professional | UE · Used equipment | $4.68 | $6.17 | $28.18 |
Cigna Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $10.96 | Professional | None | $3.39 | $3.39 | $10.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $45.71 | Professional | None | $8.32 | $8.32 | $45.71 |
Oscar Health Setting Professional Modifier None Typical Low $9.33 Median $10.96 Typical High $11.48 | Professional | None | $9.33 | $10.96 | $11.48 |
United Setting Professional Modifier None Typical Low $2.69 Median $4.07 Typical High $15.49 | Professional | None | $2.69 | $4.07 | $15.49 |
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 $2.51 Median $2.57 Typical High $3.02 | Professional | 52 · Reduced service | $2.51 | $2.57 | $3.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.00 Median $1.02 Typical High $1.20 | Professional | 53 · Discontinued | $1.00 | $1.02 | $1.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3.80 Median $3.89 Typical High $4.47 | Professional | 54 · Surgery only | $3.80 | $3.89 | $4.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.76 Median $0.78 Typical High $0.89 | Professional | 55 · Aftercare only | $0.76 | $0.78 | $0.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.50 Median $0.52 Typical High $0.60 | Professional | 56 · Pre-op care only | $0.50 | $0.52 | $0.60 |
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· 12th of 51
$7.41
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.