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 $20.89 Median $20.89 Typical High $21.88 | Facility | None | $20.89 | $20.89 | $21.88 |
Aetna Setting Professional Modifier None Typical Low $16.60 Median $20.89 Typical High $21.88 | Professional | None | $16.60 | $20.89 | $21.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $26.92 Median $93.33 Typical High $97.72 | Facility | None | $26.92 | $93.33 | $97.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.95 Median $23.99 Typical High $123.03 | Professional | None | $19.95 | $23.99 | $123.03 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.19 Median $2.69 Typical High $12.30 | Professional | RR · Rental | $2.19 | $2.69 | $12.30 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $16.22 Median $19.95 Typical High $91.20 | Professional | UE · Used equipment | $16.22 | $19.95 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | None | $9.55 | $9.55 | $9.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $20.42 Median $26.92 Typical High $26.92 | Professional | None | $20.42 | $26.92 | $26.92 |
Oscar Health Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | None | $10.00 | $10.00 | $10.00 |
United Setting Professional Modifier None Typical Low $8.71 Median $12.30 Typical High $57.54 | Professional | None | $8.71 | $12.30 | $57.54 |
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 $8.32 Median $10.47 Typical High $10.96 | Professional | 52 · Reduced service | $8.32 | $10.47 | $10.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.39 Median $4.17 Typical High $4.37 | Professional | 53 · Discontinued | $3.39 | $4.17 | $4.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $3.16 Typical High $3.31 | Professional | 55 · Aftercare only | $2.51 | $3.16 | $3.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.70 Median $2.09 Typical High $2.19 | Professional | 56 · Pre-op care only | $1.70 | $2.09 | $2.19 |
Oscar Health Setting Professional Modifier MV Typical Low $25.12 Median $64.57 Typical High $64.57 | Professional | MV | $25.12 | $64.57 | $64.57 |
Oscar Health Setting Professional Modifier SM · Second surgical opinion Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | SM · Second surgical opinion | $10.00 | $10.00 | $10.00 |
Oscar Health Setting Professional Modifier SV · Delivered, not used Typical Low $25.12 Median $64.57 Typical High $64.57 | Professional | SV · Delivered, not used | $25.12 | $64.57 | $64.57 |
Where Georgia sits
The same service costs 3.0 times more in Montana 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· 3rd of 51
$23.44
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.