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 $15.14 Median $15.14 Typical High $19.95 | Facility | None | $15.14 | $15.14 | $19.95 |
Aetna Setting Professional Modifier None Typical Low $14.79 Median $15.14 Typical High $17.38 | Professional | None | $14.79 | $15.14 | $17.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $18.20 Median $23.99 Typical High $109.65 | Professional | None | $18.20 | $23.99 | $109.65 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.74 Median $2.40 Typical High $10.96 | Professional | RR · Rental | $1.74 | $2.40 | $10.96 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $13.49 Median $18.20 Typical High $83.18 | Professional | UE · Used equipment | $13.49 | $18.20 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $32.36 | Professional | None | $9.77 | $9.77 | $32.36 |
Kaiser Permanente Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $131.83 | Professional | None | $23.99 | $23.99 | $131.83 |
Oscar Health Setting Professional Modifier None Typical Low $27.54 Median $31.62 Typical High $33.88 | Professional | None | $27.54 | $31.62 | $33.88 |
United Setting Professional Modifier None Typical Low $7.94 Median $11.75 Typical High $42.66 | Professional | None | $7.94 | $11.75 | $42.66 |
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 $7.41 Median $7.59 Typical High $8.71 | Professional | 52 · Reduced service | $7.41 | $7.59 | $8.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.95 Median $3.02 Typical High $3.47 | Professional | 53 · Discontinued | $2.95 | $3.02 | $3.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $10.96 Median $11.22 Typical High $13.18 | Professional | 54 · Surgery only | $10.96 | $11.22 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.19 Median $2.24 Typical High $2.63 | Professional | 55 · Aftercare only | $2.19 | $2.24 | $2.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.48 Median $1.51 Typical High $1.74 | Professional | 56 · Pre-op care only | $1.48 | $1.51 | $1.74 |
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
$21.88
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.