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 $21.38 Median $21.38 Typical High $27.54 | Facility | None | $21.38 | $21.38 | $27.54 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $21.88 Typical High $56.23 | Professional | None | $20.89 | $21.88 | $56.23 |
Ambetter Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $61.66 | Professional | None | $42.66 | $42.66 | $61.66 |
Anthem BCBS Setting Professional Modifier None Typical Low $24.55 Median $32.36 Typical High $154.88 | Professional | None | $24.55 | $32.36 | $154.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.45 Median $3.39 Typical High $15.49 | Professional | RR · Rental | $2.45 | $3.39 | $15.49 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $19.05 Median $25.12 Typical High $114.82 | Professional | UE · Used equipment | $19.05 | $25.12 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $45.71 | Professional | None | $13.80 | $13.80 | $45.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $144.54 | Professional | None | $33.88 | $33.88 | $144.54 |
Oscar Health Setting Professional Modifier None Typical Low $38.90 Median $44.67 Typical High $47.86 | Professional | None | $38.90 | $44.67 | $47.86 |
United Setting Professional Modifier None Typical Low $10.96 Median $16.60 Typical High $60.26 | Professional | None | $10.96 | $16.60 | $60.26 |
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 $10.23 Median $10.47 Typical High $12.02 | Professional | 52 · Reduced service | $10.23 | $10.47 | $12.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $4.27 Typical High $4.79 | Professional | 53 · Discontinued | $4.07 | $4.27 | $4.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $15.49 Median $15.85 Typical High $18.20 | Professional | 54 · Surgery only | $15.49 | $15.85 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $3.16 Typical High $3.63 | Professional | 55 · Aftercare only | $3.09 | $3.16 | $3.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.14 Typical High $2.40 | Professional | 56 · Pre-op care only | $2.04 | $2.14 | $2.40 |
Where Georgia sits
The same service costs 2.6 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· 12th of 51
$30.20
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.