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 $63.10 Median $63.10 Typical High $64.57 | Facility | None | $63.10 | $63.10 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $63.10 Typical High $64.57 | Professional | None | $58.88 | $63.10 | $64.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $79.43 Median $275.42 Typical High $295.12 | Facility | None | $79.43 | $275.42 | $295.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $63.10 Median $72.44 Typical High $426.58 | Professional | None | $63.10 | $72.44 | $426.58 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.46 Median $9.33 Typical High $42.66 | Professional | RR · Rental | $6.46 | $9.33 | $42.66 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $48.98 Median $70.79 Typical High $323.59 | Professional | UE · Used equipment | $48.98 | $70.79 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $63.10 Median $79.43 Typical High $79.43 | Professional | None | $63.10 | $79.43 | $79.43 |
Oscar Health Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
United Setting Professional Modifier None Typical Low $19.05 Median $35.48 Typical High $52.48 | Professional | None | $19.05 | $35.48 | $52.48 |
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 $29.51 Median $30.90 Typical High $32.36 | Professional | 52 · Reduced service | $29.51 | $30.90 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $12.59 Typical High $12.88 | Professional | 53 · Discontinued | $11.75 | $12.59 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $9.33 Typical High $9.77 | Professional | 55 · Aftercare only | $8.91 | $9.33 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $6.31 Typical High $6.46 | Professional | 56 · Pre-op care only | $5.89 | $6.31 | $6.46 |
Oscar Health Setting Professional Modifier MV Typical Low $25.12 Median $54.95 Typical High $54.95 | Professional | MV | $25.12 | $54.95 | $54.95 |
Oscar Health Setting Professional Modifier PL · Progressive lenses Typical Low $25.12 Median $54.95 Typical High $54.95 | Professional | PL · Progressive lenses | $25.12 | $54.95 | $54.95 |
Oscar Health Setting Professional Modifier SV · Delivered, not used Typical Low $25.12 Median $54.95 Typical High $54.95 | Professional | SV · Delivered, not used | $25.12 | $54.95 | $54.95 |
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· 6th of 51
$69.18
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.