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 $15.85 Median $15.85 Typical High $20.89 | Facility | None | $15.85 | $15.85 | $20.89 |
Aetna Setting Professional Modifier None Typical Low $15.49 Median $15.85 Typical High $20.89 | Professional | None | $15.49 | $15.85 | $20.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $17.78 Median $24.55 Typical High $117.49 | Professional | None | $17.78 | $24.55 | $117.49 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.82 Median $2.51 Typical High $11.75 | Professional | RR · Rental | $1.82 | $2.51 | $11.75 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $14.45 Median $19.05 Typical High $87.10 | Professional | UE · Used equipment | $14.45 | $19.05 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $33.88 | Professional | None | $10.47 | $10.47 | $33.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $85.11 | Professional | None | $25.70 | $25.70 | $85.11 |
Oscar Health Setting Professional Modifier None Typical Low $28.84 Median $33.88 Typical High $35.48 | Professional | None | $28.84 | $33.88 | $35.48 |
United Setting Professional Modifier None Typical Low $8.32 Median $12.59 Typical High $45.71 | Professional | None | $8.32 | $12.59 | $45.71 |
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 $7.76 Median $7.94 Typical High $9.12 | Professional | 52 · Reduced service | $7.76 | $7.94 | $9.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.09 Median $3.16 Typical High $3.63 | Professional | 53 · Discontinued | $3.09 | $3.16 | $3.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $11.75 Median $12.02 Typical High $13.49 | Professional | 54 · Surgery only | $11.75 | $12.02 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.34 Median $2.40 Typical High $2.69 | Professional | 55 · Aftercare only | $2.34 | $2.40 | $2.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.55 Median $1.58 Typical High $1.82 | Professional | 56 · Pre-op care only | $1.55 | $1.58 | $1.82 |
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
$22.91
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.