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 $186.21 Median $186.21 Typical High $263.03 | Facility | None | $186.21 | $186.21 | $263.03 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $239.88 Typical High $489.78 | Professional | None | $186.21 | $239.88 | $489.78 |
Ambetter Setting Professional Modifier None Typical Low $186.21 Median $691.83 Typical High $794.33 | Professional | None | $186.21 | $691.83 | $794.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $316.23 Median $1,096.48 Typical High $1,174.90 | Facility | None | $316.23 | $1,096.48 | $1,174.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $281.84 Median $398.11 Typical High $1,288.25 | Professional | None | $281.84 | $398.11 | $1,288.25 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $28.18 Median $41.69 Typical High $131.83 | Professional | RR · Rental | $28.18 | $41.69 | $131.83 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $213.80 Median $309.03 Typical High $977.24 | Professional | UE · Used equipment | $213.80 | $309.03 | $977.24 |
CareSource Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Facility | None | $309.03 | $309.03 | $309.03 |
CareSource Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Cigna Setting Facility Modifier RR · Rental Typical Low $30.20 Median $30.20 Typical High $30.20 | Facility | RR · Rental | $30.20 | $30.20 | $30.20 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $426.58 | Professional | None | $218.78 | $218.78 | $426.58 |
Cigna Setting Professional Modifier RR · Rental Typical Low $25.70 Median $25.70 Typical High $30.20 | Professional | RR · Rental | $25.70 | $25.70 | $30.20 |
Kaiser Permanente Setting Professional Modifier None Typical Low $288.40 Median $316.23 Typical High $602.56 | Professional | None | $288.40 | $316.23 | $602.56 |
United Setting Professional Modifier None Typical Low $165.96 Median $251.19 Typical High $398.11 | Professional | None | $165.96 | $251.19 | $398.11 |
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 $89.13 Median $93.33 Typical High $134.90 | Professional | 52 · Reduced service | $89.13 | $93.33 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $38.02 Typical High $53.70 | Professional | 53 · Discontinued | $35.48 | $38.02 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $28.18 Typical High $40.74 | Professional | 55 · Aftercare only | $26.92 | $28.18 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $18.62 Typical High $26.92 | Professional | 56 · Pre-op care only | $17.78 | $18.62 | $26.92 |
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· 8th of 51
$355
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.