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 $39.81 Median $39.81 Typical High $56.23 | Facility | None | $39.81 | $39.81 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $41.69 Typical High $56.23 | Professional | None | $39.81 | $41.69 | $56.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $87.10 Median $295.12 Typical High $316.23 | Facility | None | $87.10 | $295.12 | $316.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $43.65 Median $74.13 Typical High $281.84 | Professional | None | $43.65 | $74.13 | $281.84 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.27 Median $9.77 Typical High $44.67 | Professional | RR · Rental | $4.27 | $9.77 | $44.67 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $31.62 Median $74.13 Typical High $338.84 | Professional | UE · Used equipment | $31.62 | $74.13 | $338.84 |
CareSource Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
CareSource Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Facility | None | $46.77 | $46.77 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $114.82 | Professional | None | $33.88 | $33.88 | $114.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $60.26 Median $87.10 Typical High $123.03 | Professional | None | $60.26 | $87.10 | $123.03 |
United Setting Facility Modifier None Typical Low $19.05 Median $19.05 Typical High $36.31 | Facility | None | $19.05 | $19.05 | $36.31 |
United Setting Professional Modifier None Typical Low $28.18 Median $42.66 Typical High $107.15 | Professional | None | $28.18 | $42.66 | $107.15 |
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 $19.95 Median $19.95 Typical High $26.92 | Professional | 52 · Reduced service | $19.95 | $19.95 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $7.94 Typical High $10.72 | Professional | 53 · Discontinued | $7.94 | $7.94 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.03 Typical High $7.94 | Professional | 55 · Aftercare only | $6.03 | $6.03 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $3.98 Typical High $5.37 | Professional | 56 · Pre-op care only | $3.98 | $3.98 | $5.37 |
Where Georgia sits
The same service costs 2.9 times more in Kansas 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· 12th of 51
$70.79
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.