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 $61.66 Median $61.66 Typical High $64.57 | Facility | None | $61.66 | $61.66 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $61.66 Typical High $64.57 | Professional | None | $50.12 | $61.66 | $64.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $77.62 Median $269.15 Typical High $288.40 | Facility | None | $77.62 | $269.15 | $288.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $58.88 Median $70.79 Typical High $363.08 | Professional | None | $58.88 | $70.79 | $363.08 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.46 Median $7.94 Typical High $36.31 | Professional | RR · Rental | $6.46 | $7.94 | $36.31 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $47.86 Median $60.26 Typical High $275.42 | Professional | UE · Used equipment | $47.86 | $60.26 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $61.66 Median $77.62 Typical High $77.62 | Professional | None | $61.66 | $77.62 | $77.62 |
Oscar Health Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $104.71 | Professional | None | $19.95 | $19.95 | $104.71 |
United Setting Professional Modifier None Typical Low $10.96 Median $33.11 Typical High $51.29 | Professional | None | $10.96 | $33.11 | $51.29 |
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 $25.12 Median $30.90 Typical High $32.36 | Professional | 52 · Reduced service | $25.12 | $30.90 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $12.30 Typical High $12.88 | Professional | 53 · Discontinued | $10.00 | $12.30 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $9.12 Typical High $9.55 | Professional | 55 · Aftercare only | $7.41 | $9.12 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $6.17 Typical High $6.46 | Professional | 56 · Pre-op care only | $5.01 | $6.17 | $6.46 |
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 Montana than in Indiana. 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· 4th of 51
$67.61
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.