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 $53.70 Median $53.70 Typical High $70.79 | Facility | None | $53.70 | $53.70 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $53.70 Typical High $60.26 | Professional | None | $52.48 | $53.70 | $60.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $58.88 Median $81.28 Typical High $389.05 | Professional | None | $58.88 | $81.28 | $389.05 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.17 Median $8.51 Typical High $38.90 | Professional | RR · Rental | $6.17 | $8.51 | $38.90 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $47.86 Median $64.57 Typical High $295.12 | Professional | UE · Used equipment | $47.86 | $64.57 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $114.82 | Professional | None | $34.67 | $34.67 | $114.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $234.42 | Professional | None | $85.11 | $85.11 | $234.42 |
Oscar Health Setting Professional Modifier None Typical Low $97.72 Median $112.20 Typical High $120.23 | Professional | None | $97.72 | $112.20 | $120.23 |
United Setting Professional Modifier None Typical Low $27.54 Median $41.69 Typical High $151.36 | Professional | None | $27.54 | $41.69 | $151.36 |
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 $25.70 Median $26.92 Typical High $30.20 | Professional | 52 · Reduced service | $25.70 | $26.92 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $10.72 Typical High $12.02 | Professional | 53 · Discontinued | $10.47 | $10.72 | $12.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $39.81 Typical High $45.71 | Professional | 54 · Surgery only | $38.90 | $39.81 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $7.94 Typical High $9.12 | Professional | 55 · Aftercare only | $7.76 | $7.94 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.37 Typical High $6.03 | Professional | 56 · Pre-op care only | $5.25 | $5.37 | $6.03 |
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
$75.86
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.