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 $42.66 Median $42.66 Typical High $47.86 | Facility | None | $42.66 | $42.66 | $47.86 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $56.23 | Professional | None | $42.66 | $42.66 | $56.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $93.33 Median $323.59 Typical High $338.84 | Facility | None | $93.33 | $323.59 | $338.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $83.18 Typical High $426.58 | Professional | None | $60.26 | $83.18 | $426.58 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.92 Median $9.33 Typical High $42.66 | Professional | RR · Rental | $6.92 | $9.33 | $42.66 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $52.48 Median $69.18 Typical High $316.23 | Professional | UE · Used equipment | $52.48 | $69.18 | $316.23 |
CareSource Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
CareSource Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $104.71 | Professional | None | $77.62 | $77.62 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Cigna Setting Facility Modifier RR · Rental Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | RR · Rental | $64.57 | $64.57 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $123.03 | Professional | None | $54.95 | $54.95 | $123.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $199.53 | Professional | None | $93.33 | $93.33 | $199.53 |
United Setting Professional Modifier None Typical Low $32.36 Median $60.26 Typical High $138.04 | Professional | None | $32.36 | $60.26 | $138.04 |
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 $21.38 Median $21.38 Typical High $28.18 | Professional | 52 · Reduced service | $21.38 | $21.38 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.51 Typical High $11.22 | Professional | 53 · Discontinued | $8.51 | $8.51 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $8.51 | Professional | 55 · Aftercare only | $6.46 | $6.46 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $5.62 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $5.62 |
Where Georgia sits
The same service costs 2.5 times more in Hawaii than in Rhode Island. 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· 18th of 51
$74.13
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.