How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $44.67 Median $44.67 Typical High $46.77 | Facility | None | $44.67 | $44.67 | $46.77 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $46.77 | Professional | None | $44.67 | $44.67 | $46.77 |
Anthem BCBS Setting Facility Modifier None Typical Low $57.54 Median $199.53 Typical High $208.93 | Facility | None | $57.54 | $199.53 | $208.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $42.66 Median $51.29 Typical High $338.84 | Professional | None | $42.66 | $51.29 | $338.84 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.68 Median $7.41 Typical High $33.88 | Professional | RR · Rental | $4.68 | $7.41 | $33.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $34.67 Median $56.23 Typical High $251.19 | Professional | UE · Used equipment | $34.67 | $56.23 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | None | $26.92 | $26.92 | $26.92 |
Kaiser Permanente Setting Professional Modifier None Typical Low $45.71 Median $57.54 Typical High $57.54 | Professional | None | $45.71 | $57.54 | $57.54 |
Oscar Health Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $77.62 | Professional | None | $19.95 | $19.95 | $77.62 |
United Setting Professional Modifier None Typical Low $10.96 Median $25.70 Typical High $38.02 | Professional | None | $10.96 | $25.70 | $38.02 |
7 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 $22.39 Median $22.39 Typical High $23.44 | Professional | 52 · Reduced service | $22.39 | $22.39 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $8.91 Typical High $9.33 | Professional | 53 · Discontinued | $8.91 | $8.91 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $6.76 Typical High $7.08 | Professional | 55 · Aftercare only | $6.76 | $6.76 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $4.47 Typical High $4.68 | Professional | 56 · Pre-op care only | $4.47 | $4.47 | $4.68 |
Oscar Health Setting Professional Modifier GX · Voluntary liability notice Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | GX · Voluntary liability notice | $15.14 | $15.14 | $15.14 |
Oscar Health Setting Professional Modifier LO Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | LO | $30.20 | $30.20 | $30.20 |
Oscar Health Setting Professional Modifier PL · Progressive lenses Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | PL · Progressive lenses | $15.14 | $15.14 | $15.14 |
Where Georgia sits
The same service costs 2.6 times more in Hawaii than in Utah. 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· 13th of 51
$50.12
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.