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 $5.37 Median $5.37 Typical High $7.08 | Facility | None | $5.37 | $5.37 | $7.08 |
Aetna Setting Professional Modifier None Typical Low $5.37 Median $5.89 Typical High $14.13 | Professional | None | $5.37 | $5.89 | $14.13 |
Ambetter Setting Professional Modifier None Typical Low $9.33 Median $33.11 Typical High $38.90 | Professional | None | $9.33 | $33.11 | $38.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.17 Median $8.51 Typical High $38.90 | Professional | None | $6.17 | $8.51 | $38.90 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.62 Median $0.85 Typical High $3.89 | Professional | RR · Rental | $0.62 | $0.85 | $3.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.79 Median $6.46 Typical High $29.51 | Professional | UE · Used equipment | $4.79 | $6.46 | $29.51 |
Cigna Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $11.48 | Professional | None | $3.47 | $3.47 | $11.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $56.23 | Professional | None | $8.51 | $8.51 | $56.23 |
Oscar Health Setting Professional Modifier None Typical Low $9.77 Median $11.48 Typical High $12.02 | Professional | None | $9.77 | $11.48 | $12.02 |
United Setting Professional Modifier None Typical Low $2.82 Median $4.17 Typical High $15.85 | Professional | None | $2.82 | $4.17 | $15.85 |
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 $2.63 Median $2.69 Typical High $3.09 | Professional | 52 · Reduced service | $2.63 | $2.69 | $3.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.05 Median $1.07 Typical High $1.23 | Professional | 53 · Discontinued | $1.05 | $1.07 | $1.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3.89 Median $4.07 Typical High $4.68 | Professional | 54 · Surgery only | $3.89 | $4.07 | $4.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.78 Median $0.81 Typical High $0.93 | Professional | 55 · Aftercare only | $0.78 | $0.81 | $0.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.54 Typical High $0.62 | Professional | 56 · Pre-op care only | $0.52 | $0.54 | $0.62 |
Where Georgia sits
The same service costs 4.1 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· 8th of 51
$8.13
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.