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 $87.10 Median $87.10 Typical High $91.20 | Facility | None | $87.10 | $87.10 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $87.10 Typical High $91.20 | Professional | None | $83.18 | $87.10 | $91.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $112.20 Median $389.05 Typical High $407.38 | Facility | None | $112.20 | $389.05 | $407.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $83.18 Median $100.00 Typical High $616.60 | Professional | None | $83.18 | $100.00 | $616.60 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $9.12 Median $13.80 Typical High $61.66 | Professional | RR · Rental | $9.12 | $13.80 | $61.66 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $67.61 Median $97.72 Typical High $467.74 | Professional | UE · Used equipment | $67.61 | $97.72 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $89.13 Median $112.20 Typical High $112.20 | Professional | None | $89.13 | $112.20 | $112.20 |
Oscar Health Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $151.36 | Professional | None | $34.67 | $34.67 | $151.36 |
United Setting Professional Modifier None Typical Low $12.88 Median $47.86 Typical High $72.44 | Professional | None | $12.88 | $47.86 | $72.44 |
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 $41.69 Median $43.65 Typical High $45.71 | Professional | 52 · Reduced service | $41.69 | $43.65 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $17.38 Typical High $18.20 | Professional | 53 · Discontinued | $16.60 | $17.38 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $13.18 Typical High $13.80 | Professional | 55 · Aftercare only | $12.30 | $13.18 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.71 Typical High $9.12 | Professional | 56 · Pre-op care only | $8.32 | $8.71 | $9.12 |
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 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· 8th of 51
$97.72
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.