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 $35.48 Median $35.48 Typical High $50.12 | Facility | None | $35.48 | $35.48 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $40.74 Typical High $63.10 | Professional | None | $33.88 | $40.74 | $63.10 |
Ambetter Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $60.26 Median $208.93 Typical High $223.87 | Facility | None | $60.26 | $208.93 | $223.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $75.86 Typical High $251.19 | Professional | None | $53.70 | $75.86 | $251.19 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.37 Median $7.76 Typical High $25.12 | Professional | RR · Rental | $5.37 | $7.76 | $25.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $40.74 Median $56.23 Typical High $186.21 | Professional | UE · Used equipment | $40.74 | $56.23 | $186.21 |
CareSource Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
CareSource Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $79.43 | Professional | None | $44.67 | $44.67 | $79.43 |
Kaiser Permanente Setting Professional Modifier None Typical Low $54.95 Median $60.26 Typical High $128.82 | Professional | None | $54.95 | $60.26 | $128.82 |
United Setting Professional Modifier None Typical Low $31.62 Median $46.77 Typical High $74.13 | Professional | None | $31.62 | $46.77 | $74.13 |
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 $16.98 Median $17.78 Typical High $25.70 | Professional | 52 · Reduced service | $16.98 | $17.78 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $7.08 Typical High $10.23 | Professional | 53 · Discontinued | $6.76 | $7.08 | $10.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.37 Typical High $7.59 | Professional | 55 · Aftercare only | $5.13 | $5.37 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.55 Typical High $5.13 | Professional | 56 · Pre-op care only | $3.39 | $3.55 | $5.13 |
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· 6th of 51
$67.61
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.