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 $10.72 Median $10.72 Typical High $14.13 | Facility | None | $10.72 | $10.72 | $14.13 |
Aetna Setting Professional Modifier None Typical Low $10.47 Median $10.72 Typical High $12.30 | Professional | None | $10.47 | $10.72 | $12.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.02 Median $16.60 Typical High $77.62 | Professional | None | $12.02 | $16.60 | $77.62 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.23 Median $1.74 Typical High $7.76 | Professional | RR · Rental | $1.23 | $1.74 | $7.76 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $9.55 Median $12.88 Typical High $58.88 | Professional | UE · Used equipment | $9.55 | $12.88 | $58.88 |
Cigna Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $22.91 | Professional | None | $7.08 | $7.08 | $22.91 |
Kaiser Permanente Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $54.95 | Professional | None | $16.98 | $16.98 | $54.95 |
Oscar Health Setting Professional Modifier None Typical Low $19.50 Median $22.91 Typical High $23.99 | Professional | None | $19.50 | $22.91 | $23.99 |
United Setting Professional Modifier None Typical Low $5.62 Median $8.32 Typical High $30.90 | Professional | None | $5.62 | $8.32 | $30.90 |
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 $5.25 Median $5.37 Typical High $6.17 | Professional | 52 · Reduced service | $5.25 | $5.37 | $6.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.09 Median $2.14 Typical High $2.45 | Professional | 53 · Discontinued | $2.09 | $2.14 | $2.45 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $7.76 Median $8.13 Typical High $9.12 | Professional | 54 · Surgery only | $7.76 | $8.13 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.58 Median $1.62 Typical High $1.82 | Professional | 55 · Aftercare only | $1.58 | $1.62 | $1.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.05 Median $1.07 Typical High $1.23 | Professional | 56 · Pre-op care only | $1.05 | $1.07 | $1.23 |
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
$15.49
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.