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 $46.77 Median $46.77 Typical High $48.98 | Facility | None | $46.77 | $46.77 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $46.77 Typical High $48.98 | Professional | None | $44.67 | $46.77 | $48.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $60.26 Median $208.93 Typical High $218.78 | Facility | None | $60.26 | $208.93 | $218.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $44.67 Median $53.70 Typical High $323.59 | Professional | None | $44.67 | $53.70 | $323.59 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.90 Median $7.08 Typical High $32.36 | Professional | RR · Rental | $4.90 | $7.08 | $32.36 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $37.15 Median $52.48 Typical High $239.88 | Professional | UE · Used equipment | $37.15 | $52.48 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $47.86 Median $60.26 Typical High $60.26 | Professional | None | $47.86 | $60.26 | $60.26 |
Oscar Health Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $81.28 | Professional | None | $19.95 | $19.95 | $81.28 |
United Setting Professional Modifier None Typical Low $10.96 Median $25.70 Typical High $39.81 | Professional | None | $10.96 | $25.70 | $39.81 |
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 $23.44 Typical High $24.55 | Professional | 52 · Reduced service | $22.39 | $23.44 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $9.33 Typical High $9.77 | Professional | 53 · Discontinued | $8.91 | $9.33 | $9.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $7.08 Typical High $7.41 | Professional | 55 · Aftercare only | $6.61 | $7.08 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $4.68 Typical High $4.90 | Professional | 56 · Pre-op care only | $4.47 | $4.68 | $4.90 |
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 3.0 times more in Hawaii than in Missouri. 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· 7th of 51
$52.48
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.