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 $81.28 Median $81.28 Typical High $83.18 | Facility | None | $81.28 | $81.28 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $81.28 Typical High $83.18 | Professional | None | $79.43 | $81.28 | $83.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $102.33 Median $354.81 Typical High $380.19 | Facility | None | $102.33 | $354.81 | $380.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $77.62 Median $93.33 Typical High $602.56 | Professional | None | $77.62 | $93.33 | $602.56 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.32 Median $13.18 Typical High $60.26 | Professional | RR · Rental | $8.32 | $13.18 | $60.26 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $63.10 Median $97.72 Typical High $446.68 | Professional | UE · Used equipment | $63.10 | $97.72 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
Kaiser Permanente Setting Professional Modifier None Typical Low $81.28 Median $102.33 Typical High $102.33 | Professional | None | $81.28 | $102.33 | $102.33 |
Oscar Health Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $138.04 | Professional | None | $50.12 | $50.12 | $138.04 |
United Setting Professional Modifier None Typical Low $15.14 Median $45.71 Typical High $67.61 | Professional | None | $15.14 | $45.71 | $67.61 |
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 $39.81 Median $39.81 Typical High $41.69 | Professional | 52 · Reduced service | $39.81 | $39.81 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.22 Typical High $16.60 | Professional | 53 · Discontinued | $16.22 | $16.22 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $12.59 | Professional | 55 · Aftercare only | $12.02 | $12.02 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.13 Typical High $8.32 | Professional | 56 · Pre-op care only | $7.94 | $8.13 | $8.32 |
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 2.5 times more in Montana than in Missouri. 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· 11th of 51
$89.13
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.