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 $74.13 Median $74.13 Typical High $77.62 | Facility | None | $74.13 | $74.13 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $77.62 | Professional | None | $74.13 | $74.13 | $77.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $95.50 Median $323.59 Typical High $346.74 | Facility | None | $95.50 | $323.59 | $346.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $70.79 Median $85.11 Typical High $575.44 | Professional | None | $70.79 | $85.11 | $575.44 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $7.76 Median $12.59 Typical High $57.54 | Professional | RR · Rental | $7.76 | $12.59 | $57.54 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $57.54 Median $93.33 Typical High $426.58 | Professional | UE · Used equipment | $57.54 | $93.33 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $75.86 Median $95.50 Typical High $95.50 | Professional | None | $75.86 | $95.50 | $95.50 |
Oscar Health Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $128.82 | Professional | None | $50.12 | $50.12 | $128.82 |
United Setting Professional Modifier None Typical Low $15.14 Median $41.69 Typical High $61.66 | Professional | None | $15.14 | $41.69 | $61.66 |
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 $37.15 Median $37.15 Typical High $38.90 | Professional | 52 · Reduced service | $37.15 | $37.15 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $14.79 Typical High $15.49 | Professional | 53 · Discontinued | $14.79 | $14.79 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $11.48 | Professional | 55 · Aftercare only | $11.22 | $11.22 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.41 Typical High $7.76 | Professional | 56 · Pre-op care only | $7.41 | $7.41 | $7.76 |
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 2.9 times more in Hawaii than in New York. 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
$81.28
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.