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 $9.33 Median $9.33 Typical High $13.18 | Facility | None | $9.33 | $9.33 | $13.18 |
Aetna Setting Professional Modifier None Typical Low $9.33 Median $9.77 Typical High $12.59 | Professional | None | $9.33 | $9.77 | $12.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $19.95 Median $69.18 Typical High $74.13 | Facility | None | $19.95 | $69.18 | $74.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.96 Median $17.38 Typical High $123.03 | Professional | None | $10.96 | $17.38 | $123.03 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.15 Median $2.69 Typical High $12.30 | Professional | RR · Rental | $1.15 | $2.69 | $12.30 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $8.71 Median $19.95 Typical High $91.20 | Professional | UE · Used equipment | $8.71 | $19.95 | $91.20 |
CareSource Setting Facility Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Facility | None | $16.60 | $16.60 | $16.60 |
CareSource Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | None | $16.60 | $16.60 | $16.60 |
Cigna Setting Facility Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Facility | None | $13.49 | $13.49 | $13.49 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $26.92 | Professional | None | $9.77 | $9.77 | $26.92 |
Kaiser Permanente Setting Professional Modifier None Typical Low $14.13 Median $19.95 Typical High $37.15 | Professional | None | $14.13 | $19.95 | $37.15 |
United Setting Facility Modifier None Typical Low $7.94 Median $7.94 Typical High $9.77 | Facility | None | $7.94 | $7.94 | $9.77 |
United Setting Professional Modifier None Typical Low $6.61 Median $9.77 Typical High $25.12 | Professional | None | $6.61 | $9.77 | $25.12 |
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 $4.68 Median $4.90 Typical High $6.31 | Professional | 52 · Reduced service | $4.68 | $4.90 | $6.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.86 Median $1.95 Typical High $2.51 | Professional | 53 · Discontinued | $1.86 | $1.95 | $2.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.41 Median $1.45 Typical High $1.86 | Professional | 55 · Aftercare only | $1.41 | $1.45 | $1.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.93 Median $0.98 Typical High $1.26 | Professional | 56 · Pre-op care only | $0.93 | $0.98 | $1.26 |
Where Georgia sits
The same service costs 2.5 times more in Arkansas than in Kansas. 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· 15th of 51
$16.22
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.