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 $151.36 Median $151.36 Typical High $158.49 | Facility | None | $151.36 | $151.36 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $151.36 Typical High $158.49 | Professional | None | $114.82 | $151.36 | $158.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $190.55 Median $660.69 Typical High $707.95 | Facility | None | $190.55 | $660.69 | $707.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $151.36 Median $173.78 Typical High $870.96 | Professional | None | $151.36 | $173.78 | $870.96 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $15.49 Median $19.05 Typical High $87.10 | Professional | RR · Rental | $15.49 | $19.05 | $87.10 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $117.49 Median $144.54 Typical High $660.69 | Professional | UE · Used equipment | $117.49 | $144.54 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | None | $69.18 | $69.18 | $69.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $147.91 Median $190.55 Typical High $190.55 | Professional | None | $147.91 | $190.55 | $190.55 |
Oscar Health Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $257.04 | Professional | None | $50.12 | $50.12 | $257.04 |
United Setting Professional Modifier None Typical Low $15.14 Median $81.28 Typical High $125.89 | Professional | None | $15.14 | $81.28 | $125.89 |
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 $57.54 Median $75.86 Typical High $77.62 | Professional | 52 · Reduced service | $57.54 | $75.86 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $30.20 Typical High $31.62 | Professional | 53 · Discontinued | $22.91 | $30.20 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $22.39 Typical High $23.44 | Professional | 55 · Aftercare only | $17.38 | $22.39 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $15.14 Typical High $15.85 | Professional | 56 · Pre-op care only | $11.48 | $15.14 | $15.85 |
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 3.0 times more in Hawaii than in Indiana. 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
$162
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.