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 $67.61 Median $67.61 Typical High $93.33 | Facility | None | $67.61 | $67.61 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $89.13 | Professional | None | $67.61 | $67.61 | $89.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $144.54 Median $501.19 Typical High $524.81 | Facility | None | $144.54 | $501.19 | $524.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $75.86 Median $125.89 Typical High $467.74 | Professional | None | $75.86 | $125.89 | $467.74 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $7.41 Median $16.60 Typical High $75.86 | Professional | RR · Rental | $7.41 | $16.60 | $75.86 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $54.95 Median $123.03 Typical High $562.34 | Professional | UE · Used equipment | $54.95 | $123.03 | $562.34 |
CareSource Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
CareSource Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $85.11 | Facility | None | $77.62 | $77.62 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $194.98 | Professional | None | $56.23 | $56.23 | $194.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $100.00 Median $144.54 Typical High $204.17 | Professional | None | $100.00 | $144.54 | $204.17 |
United Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $81.28 | Facility | None | $60.26 | $60.26 | $81.28 |
United Setting Professional Modifier None Typical Low $46.77 Median $70.79 Typical High $181.97 | Professional | None | $46.77 | $70.79 | $181.97 |
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 $33.11 Median $33.11 Typical High $44.67 | Professional | 52 · Reduced service | $33.11 | $33.11 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $17.78 | Professional | 53 · Discontinued | $13.49 | $13.49 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $13.49 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $8.91 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $8.91 |
Where Georgia sits
The same service costs 3.1 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· 9th of 51
$117
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.