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 $91.20 Median $91.20 Typical High $95.50 | Facility | None | $91.20 | $91.20 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $95.50 | Professional | None | $91.20 | $91.20 | $95.50 |
Anthem BCBS Setting Facility Modifier None Typical Low $117.49 Median $407.38 Typical High $426.58 | Facility | None | $117.49 | $407.38 | $426.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $87.10 Median $104.71 Typical High $660.69 | Professional | None | $87.10 | $104.71 | $660.69 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $9.55 Median $14.79 Typical High $66.07 | Professional | RR · Rental | $9.55 | $14.79 | $66.07 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $72.44 Median $109.65 Typical High $501.19 | Professional | UE · Used equipment | $72.44 | $109.65 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $93.33 Median $117.49 Typical High $117.49 | Professional | None | $93.33 | $117.49 | $117.49 |
Oscar Health Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $158.49 | Professional | None | $50.12 | $50.12 | $158.49 |
United Setting Professional Modifier None Typical Low $15.14 Median $51.29 Typical High $77.62 | Professional | None | $15.14 | $51.29 | $77.62 |
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 $45.71 Median $45.71 Typical High $47.86 | Professional | 52 · Reduced service | $45.71 | $45.71 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.20 Typical High $19.05 | Professional | 53 · Discontinued | $18.20 | $18.20 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $14.45 | Professional | 55 · Aftercare only | $13.80 | $13.80 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $9.55 | Professional | 56 · Pre-op care only | $9.12 | $9.12 | $9.55 |
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 4.2 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· 8th of 51
$102
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.