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 $30.20 Median $30.20 Typical High $39.81 | Facility | None | $30.20 | $30.20 | $39.81 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $30.20 Typical High $39.81 | Professional | None | $29.51 | $30.20 | $39.81 |
Ambetter Setting Professional Modifier None Typical Low $47.86 Median $102.33 Typical High $102.33 | Professional | None | $47.86 | $102.33 | $102.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.88 Median $45.71 Typical High $218.78 | Professional | None | $33.88 | $45.71 | $218.78 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.47 Median $4.79 Typical High $21.88 | Professional | RR · Rental | $3.47 | $4.79 | $21.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $26.30 Median $36.31 Typical High $165.96 | Professional | UE · Used equipment | $26.30 | $36.31 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $64.57 | Professional | None | $19.95 | $19.95 | $64.57 |
Kaiser Permanente Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $138.04 | Professional | None | $48.98 | $48.98 | $138.04 |
Oscar Health Setting Professional Modifier None Typical Low $54.95 Median $64.57 Typical High $67.61 | Professional | None | $54.95 | $64.57 | $67.61 |
United Setting Professional Modifier None Typical Low $15.85 Median $23.44 Typical High $87.10 | Professional | None | $15.85 | $23.44 | $87.10 |
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 $14.79 Median $15.14 Typical High $17.38 | Professional | 52 · Reduced service | $14.79 | $15.14 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $6.03 Typical High $6.92 | Professional | 53 · Discontinued | $5.89 | $6.03 | $6.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $21.88 Median $22.91 Typical High $25.70 | Professional | 54 · Surgery only | $21.88 | $22.91 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.57 Typical High $5.13 | Professional | 55 · Aftercare only | $4.47 | $4.57 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $3.02 Typical High $3.39 | Professional | 56 · Pre-op care only | $2.95 | $3.02 | $3.39 |
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
$41.69
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.