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 $12.02 Median $12.02 Typical High $12.30 | Facility | None | $12.02 | $12.02 | $12.30 |
Aetna Setting Professional Modifier None Typical Low $10.23 Median $12.02 Typical High $12.30 | Professional | None | $10.23 | $12.02 | $12.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $15.14 Median $52.48 Typical High $56.23 | Facility | None | $15.14 | $52.48 | $56.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.02 Median $14.13 Typical High $75.86 | Professional | None | $12.02 | $14.13 | $75.86 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.23 Median $1.70 Typical High $7.59 | Professional | RR · Rental | $1.23 | $1.70 | $7.59 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $9.33 Median $12.59 Typical High $57.54 | Professional | UE · Used equipment | $9.33 | $12.59 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | None | $6.03 | $6.03 | $6.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $12.02 Median $15.14 Typical High $15.14 | Professional | None | $12.02 | $15.14 | $15.14 |
Oscar Health Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | None | $20.42 | $20.42 | $20.42 |
United Setting Professional Modifier None Typical Low $4.90 Median $6.76 Typical High $11.48 | Professional | None | $4.90 | $6.76 | $11.48 |
4 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 $5.01 Median $5.89 Typical High $6.17 | Professional | 52 · Reduced service | $5.01 | $5.89 | $6.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.00 Median $2.40 Typical High $2.45 | Professional | 53 · Discontinued | $2.00 | $2.40 | $2.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $1.78 Typical High $1.86 | Professional | 55 · Aftercare only | $1.51 | $1.78 | $1.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $1.20 Typical High $1.23 | Professional | 56 · Pre-op care only | $1.00 | $1.20 | $1.23 |
Where Georgia sits
The same service costs 2.7 times more in Montana 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· 4th of 51
$13.18
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.