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 $21.38 Median $21.38 Typical High $28.18 | Facility | None | $21.38 | $21.38 | $28.18 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $21.38 Typical High $24.55 | Professional | None | $20.89 | $21.38 | $24.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $23.99 Median $33.88 Typical High $154.88 | Professional | None | $23.99 | $33.88 | $154.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.45 Median $3.47 Typical High $15.85 | Professional | RR · Rental | $2.45 | $3.47 | $15.85 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $19.50 Median $25.70 Typical High $117.49 | Professional | UE · Used equipment | $19.50 | $25.70 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $45.71 | Professional | None | $14.13 | $14.13 | $45.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $109.65 | Professional | None | $34.67 | $34.67 | $109.65 |
Oscar Health Setting Professional Modifier None Typical Low $38.90 Median $45.71 Typical High $47.86 | Professional | None | $38.90 | $45.71 | $47.86 |
United Setting Professional Modifier None Typical Low $11.22 Median $16.98 Typical High $61.66 | Professional | None | $11.22 | $16.98 | $61.66 |
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 $10.47 Median $10.72 Typical High $12.30 | Professional | 52 · Reduced service | $10.47 | $10.72 | $12.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.27 Typical High $4.90 | Professional | 53 · Discontinued | $4.17 | $4.27 | $4.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $15.85 Median $16.22 Typical High $18.20 | Professional | 54 · Surgery only | $15.85 | $16.22 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.24 Typical High $3.63 | Professional | 55 · Aftercare only | $3.16 | $3.24 | $3.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.14 Typical High $2.45 | Professional | 56 · Pre-op care only | $2.09 | $2.14 | $2.45 |
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
$30.90
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.