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 $11.48 Median $11.48 Typical High $15.14 | Facility | None | $11.48 | $11.48 | $15.14 |
Aetna Setting Professional Modifier None Typical Low $11.22 Median $11.48 Typical High $13.80 | Professional | None | $11.22 | $11.48 | $13.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.88 Median $18.20 Typical High $83.18 | Professional | None | $12.88 | $18.20 | $83.18 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.32 Median $1.82 Typical High $8.32 | Professional | RR · Rental | $1.32 | $1.82 | $8.32 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $10.23 Median $13.80 Typical High $63.10 | Professional | UE · Used equipment | $10.23 | $13.80 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $24.55 | Professional | None | $7.59 | $7.59 | $24.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $64.57 | Professional | None | $18.20 | $18.20 | $64.57 |
Oscar Health Setting Professional Modifier None Typical Low $20.89 Median $24.55 Typical High $25.70 | Professional | None | $20.89 | $24.55 | $25.70 |
United Setting Professional Modifier None Typical Low $6.03 Median $8.91 Typical High $33.11 | Professional | None | $6.03 | $8.91 | $33.11 |
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 $5.62 Median $5.75 Typical High $6.61 | Professional | 52 · Reduced service | $5.62 | $5.75 | $6.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.24 Median $2.29 Typical High $2.63 | Professional | 53 · Discontinued | $2.24 | $2.29 | $2.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.32 Median $8.71 Typical High $9.77 | Professional | 54 · Surgery only | $8.32 | $8.71 | $9.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.70 Median $1.74 Typical High $1.95 | Professional | 55 · Aftercare only | $1.70 | $1.74 | $1.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.15 Typical High $1.32 | Professional | 56 · Pre-op care only | $1.12 | $1.15 | $1.32 |
Where Georgia sits
The same service costs 2.7 times more in Idaho 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
$16.60
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.