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 $53.70 Median $53.70 Typical High $56.23 | Facility | None | $53.70 | $53.70 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $56.23 | Professional | None | $53.70 | $53.70 | $56.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $69.18 Median $234.42 Typical High $251.19 | Facility | None | $69.18 | $234.42 | $251.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $51.29 Median $61.66 Typical High $416.87 | Professional | None | $51.29 | $61.66 | $416.87 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.62 Median $9.12 Typical High $41.69 | Professional | RR · Rental | $5.62 | $9.12 | $41.69 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $41.69 Median $69.18 Typical High $309.03 | Professional | UE · Used equipment | $41.69 | $69.18 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $54.95 Median $69.18 Typical High $69.18 | Professional | None | $54.95 | $69.18 | $69.18 |
Oscar Health Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $93.33 | Professional | None | $34.67 | $34.67 | $93.33 |
United Setting Professional Modifier None Typical Low $12.88 Median $30.20 Typical High $45.71 | Professional | None | $12.88 | $30.20 | $45.71 |
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 $26.92 Median $26.92 Typical High $28.18 | Professional | 52 · Reduced service | $26.92 | $26.92 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $11.22 | Professional | 53 · Discontinued | $10.72 | $10.72 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.13 Typical High $8.32 | Professional | 55 · Aftercare only | $8.13 | $8.13 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $5.62 | Professional | 56 · Pre-op care only | $5.37 | $5.37 | $5.62 |
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 Montana than in Ohio. 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· 14th of 51
$58.88
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.