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 $70.79 Median $70.79 Typical High $74.13 | Facility | None | $70.79 | $70.79 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $70.79 Typical High $74.13 | Professional | None | $67.61 | $70.79 | $74.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $89.13 Median $309.03 Typical High $331.13 | Facility | None | $89.13 | $309.03 | $331.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $81.28 Typical High $501.19 | Professional | None | $67.61 | $81.28 | $501.19 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $7.24 Median $10.96 Typical High $50.12 | Professional | RR · Rental | $7.24 | $10.96 | $50.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $54.95 Median $83.18 Typical High $371.54 | Professional | UE · Used equipment | $54.95 | $83.18 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $72.44 Median $89.13 Typical High $89.13 | Professional | None | $72.44 | $89.13 | $89.13 |
Oscar Health Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $120.23 | Professional | None | $50.12 | $50.12 | $120.23 |
United Setting Professional Modifier None Typical Low $15.14 Median $39.81 Typical High $58.88 | Professional | None | $15.14 | $39.81 | $58.88 |
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 $33.11 Median $35.48 Typical High $36.31 | Professional | 52 · Reduced service | $33.11 | $35.48 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $14.13 Typical High $14.79 | Professional | 53 · Discontinued | $13.49 | $14.13 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.47 Typical High $10.96 | Professional | 55 · Aftercare only | $10.00 | $10.47 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.08 Typical High $7.41 | Professional | 56 · Pre-op care only | $6.76 | $7.08 | $7.41 |
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 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· 6th of 51
$77.62
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.