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 $46.77 Median $46.77 Typical High $61.66 | Facility | None | $46.77 | $46.77 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $46.77 Typical High $53.70 | Professional | None | $45.71 | $46.77 | $53.70 |
Anthem BCBS Setting Professional Modifier None Typical Low $52.48 Median $72.44 Typical High $346.74 | Professional | None | $52.48 | $72.44 | $346.74 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.37 Median $7.59 Typical High $34.67 | Professional | RR · Rental | $5.37 | $7.59 | $34.67 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $42.66 Median $56.23 Typical High $257.04 | Professional | UE · Used equipment | $42.66 | $56.23 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $100.00 | Professional | None | $30.90 | $30.90 | $100.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $281.84 | Professional | None | $75.86 | $75.86 | $281.84 |
Oscar Health Setting Professional Modifier None Typical Low $85.11 Median $100.00 Typical High $104.71 | Professional | None | $85.11 | $100.00 | $104.71 |
United Setting Professional Modifier None Typical Low $24.55 Median $37.15 Typical High $134.90 | Professional | None | $24.55 | $37.15 | $134.90 |
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 $22.91 Median $23.44 Typical High $26.92 | Professional | 52 · Reduced service | $22.91 | $23.44 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.33 Typical High $10.72 | Professional | 53 · Discontinued | $9.12 | $9.33 | $10.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $35.48 Typical High $39.81 | Professional | 54 · Surgery only | $34.67 | $35.48 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $7.08 Typical High $7.94 | Professional | 55 · Aftercare only | $6.92 | $7.08 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.68 Typical High $5.37 | Professional | 56 · Pre-op care only | $4.57 | $4.68 | $5.37 |
Where Georgia sits
The same service costs 2.8 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· 11th of 51
$67.61
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.