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 $3.47 Median $3.47 Typical High $4.47 | Facility | None | $3.47 | $3.47 | $4.47 |
Aetna Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $9.12 | Professional | None | $3.47 | $3.47 | $9.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.98 Median $5.50 Typical High $25.12 | Professional | None | $3.98 | $5.50 | $25.12 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.39 Median $0.55 Typical High $2.51 | Professional | RR · Rental | $0.39 | $0.55 | $2.51 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.09 Median $4.37 Typical High $18.62 | Professional | UE · Used equipment | $3.09 | $4.37 | $18.62 |
Cigna Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $7.41 | Professional | None | $2.24 | $2.24 | $7.41 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $36.31 | Professional | None | $5.50 | $5.50 | $36.31 |
Oscar Health Setting Professional Modifier None Typical Low $6.31 Median $7.24 Typical High $7.76 | Professional | None | $6.31 | $7.24 | $7.76 |
United Setting Professional Modifier None Typical Low $1.78 Median $2.69 Typical High $10.23 | Professional | None | $1.78 | $2.69 | $10.23 |
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 $1.66 Median $1.74 Typical High $2.00 | Professional | 52 · Reduced service | $1.66 | $1.74 | $2.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.68 Median $0.69 Typical High $0.79 | Professional | 53 · Discontinued | $0.68 | $0.69 | $0.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2.51 Median $2.57 Typical High $3.02 | Professional | 54 · Surgery only | $2.51 | $2.57 | $3.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.50 Median $0.52 Typical High $0.60 | Professional | 55 · Aftercare only | $0.50 | $0.52 | $0.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.33 Median $0.34 Typical High $0.40 | Professional | 56 · Pre-op care only | $0.33 | $0.34 | $0.40 |
Where Georgia sits
The same service costs 3.8 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· 7th 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.