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 $14.79 Median $14.79 Typical High $19.50 | Facility | None | $14.79 | $14.79 | $19.50 |
Aetna Setting Professional Modifier None Typical Low $14.79 Median $16.22 Typical High $38.90 | Professional | None | $14.79 | $16.22 | $38.90 |
Ambetter Setting Professional Modifier None Typical Low $13.49 Median $30.20 Typical High $75.86 | Professional | None | $13.49 | $30.20 | $75.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.98 Median $23.99 Typical High $109.65 | Professional | None | $16.98 | $23.99 | $109.65 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.70 Median $2.40 Typical High $10.96 | Professional | RR · Rental | $1.70 | $2.40 | $10.96 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $13.49 Median $17.78 Typical High $81.28 | Professional | UE · Used equipment | $13.49 | $17.78 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $31.62 | Professional | None | $9.77 | $9.77 | $31.62 |
Kaiser Permanente Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $117.49 | Professional | None | $23.99 | $23.99 | $117.49 |
Oscar Health Setting Professional Modifier None Typical Low $26.92 Median $31.62 Typical High $33.11 | Professional | None | $26.92 | $31.62 | $33.11 |
United Setting Professional Modifier None Typical Low $7.76 Median $11.75 Typical High $42.66 | Professional | None | $7.76 | $11.75 | $42.66 |
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 $7.24 Median $7.41 Typical High $8.51 | Professional | 52 · Reduced service | $7.24 | $7.41 | $8.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.88 Median $2.95 Typical High $3.39 | Professional | 53 · Discontinued | $2.88 | $2.95 | $3.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $10.96 Median $11.22 Typical High $12.59 | Professional | 54 · Surgery only | $10.96 | $11.22 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.19 Median $2.24 Typical High $2.51 | Professional | 55 · Aftercare only | $2.19 | $2.24 | $2.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $1.48 Typical High $1.70 | Professional | 56 · Pre-op care only | $1.45 | $1.48 | $1.70 |
Where Georgia sits
The same service costs 2.9 times more in Rhode Island 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· 12th of 51
$21.38
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.