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 $158.49 Median $158.49 Typical High $223.87 | Facility | None | $158.49 | $158.49 | $223.87 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $158.49 Typical High $229.09 | Professional | None | $151.36 | $158.49 | $229.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $269.15 Median $933.25 Typical High $1,000.00 | Facility | None | $269.15 | $933.25 | $1,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $239.88 Median $338.84 Typical High $977.24 | Professional | None | $239.88 | $338.84 | $977.24 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $23.99 Median $34.67 Typical High $112.20 | Professional | RR · Rental | $23.99 | $34.67 | $112.20 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $177.83 Median $263.03 Typical High $831.76 | Professional | UE · Used equipment | $177.83 | $263.03 | $831.76 |
CareSource Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
CareSource Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $354.81 | Professional | None | $204.17 | $204.17 | $354.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $245.47 Median $269.15 Typical High $575.44 | Professional | None | $245.47 | $269.15 | $575.44 |
United Setting Professional Modifier None Typical Low $141.25 Median $208.93 Typical High $331.13 | Professional | None | $141.25 | $208.93 | $331.13 |
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 $75.86 Median $79.43 Typical High $112.20 | Professional | 52 · Reduced service | $75.86 | $79.43 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $31.62 Typical High $45.71 | Professional | 53 · Discontinued | $30.20 | $31.62 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $23.99 Typical High $33.88 | Professional | 55 · Aftercare only | $22.91 | $23.99 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.85 Typical High $22.91 | Professional | 56 · Pre-op care only | $15.14 | $15.85 | $22.91 |
Where Georgia sits
The same service costs 2.6 times more in Hawaii than in Utah. 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· 5th of 51
$295
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.