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 $89.13 | Facility | None | $87.10 | $87.10 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $87.10 Typical High $89.13 | Professional | None | $77.62 | $87.10 | $89.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $109.65 Median $380.19 Typical High $407.38 | Facility | None | $109.65 | $380.19 | $407.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $83.18 Median $100.00 Typical High $575.44 | Professional | None | $83.18 | $100.00 | $575.44 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.91 Median $12.59 Typical High $57.54 | Professional | RR · Rental | $8.91 | $12.59 | $57.54 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $67.61 Median $95.50 Typical High $436.52 | Professional | UE · Used equipment | $67.61 | $95.50 | $436.52 |
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 $87.10 Median $109.65 Typical High $109.65 | Professional | None | $87.10 | $109.65 | $109.65 |
Oscar Health Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $147.91 | Professional | None | $50.12 | $50.12 | $147.91 |
United Setting Professional Modifier None Typical Low $15.14 Median $46.77 Typical High $72.44 | Professional | None | $15.14 | $46.77 | $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 $38.90 Median $43.65 Typical High $44.67 | Professional | 52 · Reduced service | $38.90 | $43.65 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $17.38 Typical High $17.78 | Professional | 53 · Discontinued | $15.49 | $17.38 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $12.88 Typical High $13.49 | Professional | 55 · Aftercare only | $11.75 | $12.88 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $8.71 Typical High $8.91 | Professional | 56 · Pre-op care only | $7.76 | $8.71 | $8.91 |
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 2.3 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· 5th of 51
$95.50
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.