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 $117.49 Median $117.49 Typical High $162.18 | Facility | None | $117.49 | $117.49 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $154.88 | Professional | None | $117.49 | $117.49 | $154.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $251.19 Median $870.96 Typical High $912.01 | Facility | None | $251.19 | $870.96 | $912.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $112.20 Median $218.78 Typical High $1,148.15 | Professional | None | $112.20 | $218.78 | $1,148.15 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.22 Median $25.12 Typical High $114.82 | Professional | RR · Rental | $11.22 | $25.12 | $114.82 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $83.18 Median $186.21 Typical High $851.14 | Professional | UE · Used equipment | $83.18 | $186.21 | $851.14 |
CareSource Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
CareSource Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $338.84 | Professional | None | $91.20 | $91.20 | $338.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $173.78 Median $251.19 Typical High $354.81 | Professional | None | $173.78 | $251.19 | $354.81 |
United Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $100.00 | Facility | None | $87.10 | $87.10 | $100.00 |
United Setting Professional Modifier None Typical Low $81.28 Median $123.03 Typical High $316.23 | Professional | None | $81.28 | $123.03 | $316.23 |
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 $57.54 Median $57.54 Typical High $77.62 | Professional | 52 · Reduced service | $57.54 | $57.54 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $23.44 Typical High $30.90 | Professional | 53 · Discontinued | $23.44 | $23.44 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $17.38 Typical High $23.44 | Professional | 55 · Aftercare only | $17.38 | $17.38 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $15.49 | Professional | 56 · Pre-op care only | $11.75 | $11.75 | $15.49 |
Where Georgia sits
The same service costs 2.4 times more in Hawaii than in Delaware. 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· 2nd of 51
$204
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.