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 $144.54 Median $144.54 Typical High $151.36 | Facility | None | $144.54 | $144.54 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $151.36 | Professional | None | $144.54 | $144.54 | $151.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $186.21 Median $630.96 Typical High $676.08 | Facility | None | $186.21 | $630.96 | $676.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $165.96 Typical High $1,122.02 | Professional | None | $125.89 | $165.96 | $1,122.02 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $15.14 Median $24.55 Typical High $112.20 | Professional | RR · Rental | $15.14 | $24.55 | $112.20 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $112.20 Median $186.21 Typical High $831.76 | Professional | UE · Used equipment | $112.20 | $186.21 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $147.91 Median $186.21 Typical High $186.21 | Professional | None | $147.91 | $186.21 | $186.21 |
Oscar Health Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
United Setting Professional Modifier None Typical Low $60.26 Median $81.28 Typical High $128.82 | Professional | None | $60.26 | $81.28 | $128.82 |
8 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 $72.44 Median $72.44 Typical High $75.86 | Professional | 52 · Reduced service | $72.44 | $72.44 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $30.20 | Professional | 53 · Discontinued | $28.84 | $28.84 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $21.88 Typical High $22.39 | Professional | 55 · Aftercare only | $21.88 | $21.88 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $15.14 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $15.14 |
Oscar Health Setting Professional Modifier PL · Progressive lenses Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | PL · Progressive lenses | $60.26 | $60.26 | $60.26 |
United Setting Professional Modifier CD · Dialysis lab test, bundled Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | CD · Dialysis lab test, bundled | $50.12 | $50.12 | $50.12 |
United Setting Professional Modifier CM · 80–99% impaired Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | CM · 80–99% impaired | $70.79 | $70.79 | $70.79 |
United Setting Professional Modifier XC Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | XC | $1,513.56 | $1,513.56 | $1,513.56 |
Where Georgia sits
The same service costs 2.6 times more in Minnesota than in Utah. 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· 15th of 51
$158
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.