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 $19.95 Median $19.95 Typical High $20.89 | Facility | None | $19.95 | $19.95 | $20.89 |
Aetna Setting Professional Modifier None Typical Low $19.50 Median $19.95 Typical High $20.89 | Professional | None | $19.50 | $19.95 | $20.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $25.12 Median $87.10 Typical High $93.33 | Facility | None | $25.12 | $87.10 | $93.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.05 Median $22.91 Typical High $144.54 | Professional | None | $19.05 | $22.91 | $144.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.04 Median $3.16 Typical High $14.45 | Professional | RR · Rental | $2.04 | $3.16 | $14.45 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $15.49 Median $22.91 Typical High $109.65 | Professional | UE · Used equipment | $15.49 | $22.91 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | None | $11.48 | $11.48 | $11.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $20.42 Median $25.12 Typical High $25.12 | Professional | None | $20.42 | $25.12 | $25.12 |
Oscar Health Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
United Setting Professional Modifier None Typical Low $8.32 Median $11.22 Typical High $20.42 | Professional | None | $8.32 | $11.22 | $20.42 |
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 $9.55 Median $10.00 Typical High $10.23 | Professional | 52 · Reduced service | $9.55 | $10.00 | $10.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $3.98 Typical High $4.17 | Professional | 53 · Discontinued | $3.89 | $3.98 | $4.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.88 Median $2.95 Typical High $3.09 | Professional | 55 · Aftercare only | $2.88 | $2.95 | $3.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $2.00 Typical High $2.04 | Professional | 56 · Pre-op care only | $1.91 | $2.00 | $2.04 |
Where Georgia sits
The same service costs 4.6 times more in Hawaii than in Ohio. 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· 9th of 51
$21.88
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.