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 $138.04 Median $138.04 Typical High $144.54 | Facility | None | $138.04 | $138.04 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $138.04 Typical High $144.54 | Professional | None | $104.71 | $138.04 | $144.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $173.78 Median $602.56 Typical High $645.65 | Facility | None | $173.78 | $602.56 | $645.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $144.54 Median $162.18 Typical High $794.33 | Professional | None | $144.54 | $162.18 | $794.33 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $14.45 Median $17.38 Typical High $79.43 | Professional | RR · Rental | $14.45 | $17.38 | $79.43 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $107.15 Median $131.83 Typical High $602.56 | Professional | UE · Used equipment | $107.15 | $131.83 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Kaiser Permanente Setting Professional Modifier None Typical Low $134.90 Median $173.78 Typical High $173.78 | Professional | None | $134.90 | $173.78 | $173.78 |
Oscar Health Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $234.42 | Professional | None | $50.12 | $50.12 | $234.42 |
United Setting Professional Modifier None Typical Low $15.14 Median $74.13 Typical High $114.82 | Professional | None | $15.14 | $74.13 | $114.82 |
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 $52.48 Median $69.18 Typical High $72.44 | Professional | 52 · Reduced service | $52.48 | $69.18 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $27.54 Typical High $28.84 | Professional | 53 · Discontinued | $21.38 | $27.54 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $20.42 Typical High $21.38 | Professional | 55 · Aftercare only | $15.85 | $20.42 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $13.80 Typical High $14.45 | Professional | 56 · Pre-op care only | $10.47 | $13.80 | $14.45 |
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 2.9 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· 4th of 51
$151
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.