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 $67.61 Median $67.61 Typical High $70.79 | Facility | None | $67.61 | $67.61 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $67.61 Typical High $70.79 | Professional | None | $63.10 | $67.61 | $70.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $85.11 Median $295.12 Typical High $316.23 | Facility | None | $85.11 | $295.12 | $316.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $64.57 Median $77.62 Typical High $478.63 | Professional | None | $64.57 | $77.62 | $478.63 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.92 Median $10.47 Typical High $47.86 | Professional | RR · Rental | $6.92 | $10.47 | $47.86 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $52.48 Median $79.43 Typical High $354.81 | Professional | UE · Used equipment | $52.48 | $79.43 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $69.18 Median $85.11 Typical High $85.11 | Professional | None | $69.18 | $85.11 | $85.11 |
Oscar Health Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $114.82 | Professional | None | $50.12 | $50.12 | $114.82 |
United Setting Professional Modifier None Typical Low $15.14 Median $38.02 Typical High $56.23 | Professional | None | $15.14 | $38.02 | $56.23 |
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 $31.62 Median $33.88 Typical High $34.67 | Professional | 52 · Reduced service | $31.62 | $33.88 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $13.49 Typical High $14.13 | Professional | 53 · Discontinued | $12.59 | $13.49 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $10.00 Typical High $10.47 | Professional | 55 · Aftercare only | $9.33 | $10.00 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.76 Typical High $7.08 | Professional | 56 · Pre-op care only | $6.31 | $6.76 | $7.08 |
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 2.7 times more in Hawaii than in Utah. 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
$74.13
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.