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 $199.53 Median $199.53 Typical High $281.84 | Facility | None | $199.53 | $199.53 | $281.84 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $251.19 Typical High $501.19 | Professional | None | $199.53 | $251.19 | $501.19 |
Ambetter Setting Professional Modifier None Typical Low $218.78 Median $562.34 Typical High $812.83 | Professional | None | $218.78 | $562.34 | $812.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $426.58 Median $1,479.11 Typical High $1,584.89 | Facility | None | $426.58 | $1,479.11 | $1,584.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $234.42 Median $371.54 Typical High $1,584.89 | Professional | None | $234.42 | $371.54 | $1,584.89 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $25.12 Median $56.23 Typical High $257.04 | Professional | RR · Rental | $25.12 | $56.23 | $257.04 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $190.55 Median $426.58 Typical High $1,949.84 | Professional | UE · Used equipment | $190.55 | $426.58 | $1,949.84 |
CareSource Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Facility | None | $354.81 | $354.81 | $354.81 |
CareSource Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $346.74 | Facility | None | $316.23 | $316.23 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $575.44 | Professional | None | $229.09 | $229.09 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $302.00 Median $426.58 Typical High $630.96 | Professional | None | $302.00 | $426.58 | $630.96 |
United Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $269.15 | Facility | None | $245.47 | $245.47 | $269.15 |
United Setting Professional Modifier None Typical Low $141.25 Median $208.93 Typical High $537.03 | Professional | None | $141.25 | $208.93 | $537.03 |
5 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 $100.00 Median $104.71 Typical High $141.25 | Professional | 52 · Reduced service | $100.00 | $104.71 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $41.69 Typical High $56.23 | Professional | 53 · Discontinued | $39.81 | $41.69 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.90 Typical High $41.69 | Professional | 55 · Aftercare only | $30.20 | $30.90 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $20.89 Typical High $28.18 | Professional | 56 · Pre-op care only | $19.95 | $20.89 | $28.18 |
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $323.59 Median $323.59 Typical High $812.83 | Professional | KX · Policy requirements met | $323.59 | $323.59 | $812.83 |
Where Georgia sits
The same service costs 2.6 times more in Hawaii than in Arizona. 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· 17th of 51
$347
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.