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 $141.25 Median $141.25 Typical High $147.91 | Facility | None | $141.25 | $141.25 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $147.91 | Professional | None | $141.25 | $141.25 | $147.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $177.83 Median $616.60 Typical High $660.69 | Facility | None | $177.83 | $616.60 | $660.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $162.18 Typical High $1,096.48 | Professional | None | $134.90 | $162.18 | $1,096.48 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $14.79 Median $23.99 Typical High $109.65 | Professional | RR · Rental | $14.79 | $23.99 | $109.65 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $109.65 Median $177.83 Typical High $812.83 | Professional | UE · Used equipment | $109.65 | $177.83 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
Kaiser Permanente Setting Professional Modifier None Typical Low $144.54 Median $177.83 Typical High $181.97 | Professional | None | $144.54 | $177.83 | $181.97 |
Oscar Health Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $239.88 | Professional | None | $50.12 | $50.12 | $239.88 |
United Setting Professional Modifier None Typical Low $15.14 Median $75.86 Typical High $117.49 | Professional | None | $15.14 | $75.86 | $117.49 |
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 $70.79 Median $70.79 Typical High $74.13 | Professional | 52 · Reduced service | $70.79 | $70.79 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $28.18 Typical High $29.51 | Professional | 53 · Discontinued | $28.18 | $28.18 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $21.88 | Professional | 55 · Aftercare only | $20.89 | $20.89 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.13 Typical High $14.79 | Professional | 56 · Pre-op care only | $14.13 | $14.13 | $14.79 |
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 5.0 times more in Hawaii than in Florida. 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· 9th of 51
$155
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.