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 $7.41 Median $7.41 Typical High $9.77 | Facility | None | $7.41 | $7.41 | $9.77 |
Aetna Setting Professional Modifier None Typical Low $7.24 Median $7.41 Typical High $19.50 | Professional | None | $7.24 | $7.41 | $19.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.91 Median $11.22 Typical High $53.70 | Professional | None | $8.91 | $11.22 | $53.70 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.85 Median $1.20 Typical High $5.37 | Professional | RR · Rental | $0.85 | $1.20 | $5.37 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $6.76 Median $8.91 Typical High $40.74 | Professional | UE · Used equipment | $6.76 | $8.91 | $40.74 |
Cigna Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $15.85 | Professional | None | $4.90 | $4.90 | $15.85 |
Kaiser Permanente Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $57.54 | Professional | None | $12.02 | $12.02 | $57.54 |
Oscar Health Setting Professional Modifier None Typical Low $13.49 Median $15.85 Typical High $16.60 | Professional | None | $13.49 | $15.85 | $16.60 |
United Setting Professional Modifier None Typical Low $3.89 Median $5.75 Typical High $21.88 | Professional | None | $3.89 | $5.75 | $21.88 |
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 $3.63 Median $3.72 Typical High $4.27 | Professional | 52 · Reduced service | $3.63 | $3.72 | $4.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.45 Median $1.48 Typical High $1.70 | Professional | 53 · Discontinued | $1.45 | $1.48 | $1.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $5.37 Median $5.62 Typical High $6.31 | Professional | 54 · Surgery only | $5.37 | $5.62 | $6.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.10 Median $1.12 Typical High $1.26 | Professional | 55 · Aftercare only | $1.10 | $1.12 | $1.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.72 Median $0.74 Typical High $0.85 | Professional | 56 · Pre-op care only | $0.72 | $0.74 | $0.85 |
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
$10.72
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.