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 $17.78 Median $17.78 Typical High $18.20 | Facility | None | $17.78 | $17.78 | $18.20 |
Aetna Setting Professional Modifier None Typical Low $16.22 Median $17.78 Typical High $18.20 | Professional | None | $16.22 | $17.78 | $18.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $22.39 Median $77.62 Typical High $83.18 | Facility | None | $22.39 | $77.62 | $83.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.98 Median $20.42 Typical High $123.03 | Professional | None | $16.98 | $20.42 | $123.03 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.82 Median $2.69 Typical High $12.30 | Professional | RR · Rental | $1.82 | $2.69 | $12.30 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $13.80 Median $19.50 Typical High $93.33 | Professional | UE · Used equipment | $13.80 | $19.50 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
Kaiser Permanente Setting Professional Modifier None Typical Low $18.20 Median $22.39 Typical High $22.39 | Professional | None | $18.20 | $22.39 | $22.39 |
Oscar Health Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
United Setting Professional Modifier None Typical Low $6.03 Median $10.00 Typical High $14.79 | Professional | None | $6.03 | $10.00 | $14.79 |
5 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 $8.13 Median $8.91 Typical High $9.12 | Professional | 52 · Reduced service | $8.13 | $8.91 | $9.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.24 Median $3.55 Typical High $3.72 | Professional | 53 · Discontinued | $3.24 | $3.55 | $3.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.45 Median $2.63 Typical High $2.75 | Professional | 55 · Aftercare only | $2.45 | $2.63 | $2.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $1.78 Typical High $1.82 | Professional | 56 · Pre-op care only | $1.62 | $1.78 | $1.82 |
Oscar Health Setting Professional Modifier BS Typical Low $7.08 Median $15.14 Typical High $15.14 | Professional | BS | $7.08 | $15.14 | $15.14 |
Where Georgia sits
The same service costs 3.2 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· 7th of 51
$19.50
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.