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 $4.57 Median $4.57 Typical High $6.03 | Facility | None | $4.57 | $4.57 | $6.03 |
Aetna Setting Professional Modifier None Typical Low $4.47 Median $4.57 Typical High $5.25 | Professional | None | $4.47 | $4.57 | $5.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.13 Median $7.41 Typical High $33.88 | Professional | None | $5.13 | $7.41 | $33.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.52 Median $0.74 Typical High $3.39 | Professional | RR · Rental | $0.52 | $0.74 | $3.39 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.17 Median $5.50 Typical High $25.12 | Professional | UE · Used equipment | $4.17 | $5.50 | $25.12 |
Cigna Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $9.77 | Professional | None | $3.02 | $3.02 | $9.77 |
Kaiser Permanente Setting Professional Modifier None Typical Low $7.41 Median $7.41 Typical High $27.54 | Professional | None | $7.41 | $7.41 | $27.54 |
Oscar Health Setting Professional Modifier None Typical Low $8.32 Median $9.77 Typical High $10.23 | Professional | None | $8.32 | $9.77 | $10.23 |
United Setting Professional Modifier None Typical Low $2.40 Median $3.63 Typical High $13.80 | Professional | None | $2.40 | $3.63 | $13.80 |
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 $2.24 Median $2.29 Typical High $2.63 | Professional | 52 · Reduced service | $2.24 | $2.29 | $2.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.89 Median $0.91 Typical High $1.05 | Professional | 53 · Discontinued | $0.89 | $0.91 | $1.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3.39 Median $3.47 Typical High $3.89 | Professional | 54 · Surgery only | $3.39 | $3.47 | $3.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.68 Median $0.69 Typical High $0.79 | Professional | 55 · Aftercare only | $0.68 | $0.69 | $0.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.45 Median $0.46 Typical High $0.52 | Professional | 56 · Pre-op care only | $0.45 | $0.46 | $0.52 |
Where Georgia sits
The same service costs 2.7 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
$6.61
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.