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 $3.63 Median $3.63 Typical High $4.79 | Facility | None | $3.63 | $3.63 | $4.79 |
Aetna Setting Professional Modifier None Typical Low $3.63 Median $3.98 Typical High $9.55 | Professional | None | $3.63 | $3.98 | $9.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.57 Median $5.75 Typical High $26.30 | Professional | None | $4.57 | $5.75 | $26.30 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.42 Median $0.58 Typical High $2.63 | Professional | RR · Rental | $0.42 | $0.58 | $2.63 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.24 Median $4.37 Typical High $19.95 | Professional | UE · Used equipment | $3.24 | $4.37 | $19.95 |
Cigna Setting Professional Modifier None Typical Low $2.34 Median $2.34 Typical High $7.76 | Professional | None | $2.34 | $2.34 | $7.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5.75 Median $5.75 Typical High $29.51 | Professional | None | $5.75 | $5.75 | $29.51 |
Oscar Health Setting Professional Modifier None Typical Low $6.61 Median $7.76 Typical High $8.13 | Professional | None | $6.61 | $7.76 | $8.13 |
United Setting Professional Modifier None Typical Low $1.91 Median $2.82 Typical High $10.72 | Professional | None | $1.91 | $2.82 | $10.72 |
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 $1.78 Median $1.82 Typical High $2.09 | Professional | 52 · Reduced service | $1.78 | $1.82 | $2.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.71 Median $0.72 Typical High $0.83 | Professional | 53 · Discontinued | $0.71 | $0.72 | $0.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2.63 Median $2.69 Typical High $3.16 | Professional | 54 · Surgery only | $2.63 | $2.69 | $3.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.54 Typical High $0.63 | Professional | 55 · Aftercare only | $0.52 | $0.54 | $0.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.35 Median $0.36 Typical High $0.42 | Professional | 56 · Pre-op care only | $0.35 | $0.36 | $0.42 |
Where Georgia sits
The same service costs 3.0 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· 11th of 51
$5.37
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.