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 $33.88 Median $33.88 Typical High $44.67 | Facility | None | $33.88 | $33.88 | $44.67 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $36.31 Typical High $52.48 | Professional | None | $33.11 | $36.31 | $52.48 |
Ambetter Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | None | $38.90 | $38.90 | $38.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $54.95 Median $190.55 Typical High $204.17 | Facility | None | $54.95 | $190.55 | $204.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.90 Median $48.98 Typical High $302.00 | Professional | None | $30.90 | $48.98 | $302.00 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.09 Median $5.50 Typical High $30.20 | Professional | RR · Rental | $3.09 | $5.50 | $30.20 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $22.91 Median $41.69 Typical High $223.87 | Professional | UE · Used equipment | $22.91 | $41.69 | $223.87 |
CareSource Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
CareSource Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
Cigna Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $74.13 | Professional | None | $25.70 | $25.70 | $74.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $38.90 Median $54.95 Typical High $75.86 | Professional | None | $38.90 | $54.95 | $75.86 |
United Setting Professional Modifier None Typical Low $17.78 Median $26.92 Typical High $75.86 | Professional | None | $17.78 | $26.92 | $75.86 |
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 $16.60 Median $16.98 Typical High $21.38 | Professional | 52 · Reduced service | $16.60 | $16.98 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $6.92 Typical High $8.71 | Professional | 53 · Discontinued | $6.61 | $6.92 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $5.13 Typical High $6.46 | Professional | 55 · Aftercare only | $5.01 | $5.13 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.39 Typical High $4.37 | Professional | 56 · Pre-op care only | $3.31 | $3.39 | $4.37 |
Where Georgia sits
The same service costs 2.2 times more in Hawaii 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· 11th of 51
$48.98
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.