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 $32.36 Median $32.36 Typical High $45.71 | Facility | None | $32.36 | $32.36 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $33.88 Typical High $45.71 | Professional | None | $32.36 | $33.88 | $45.71 |
Ambetter Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $69.18 Median $239.88 Typical High $257.04 | Facility | None | $69.18 | $239.88 | $257.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.02 Median $60.26 Typical High $263.03 | Professional | None | $38.02 | $60.26 | $263.03 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.07 Median $9.12 Typical High $41.69 | Professional | RR · Rental | $4.07 | $9.12 | $41.69 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $30.20 Median $69.18 Typical High $316.23 | Professional | UE · Used equipment | $30.20 | $69.18 | $316.23 |
CareSource Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
CareSource Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $93.33 | Professional | None | $26.92 | $26.92 | $93.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $48.98 Median $69.18 Typical High $125.89 | Professional | None | $48.98 | $69.18 | $125.89 |
United Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
United Setting Professional Modifier None Typical Low $22.91 Median $33.88 Typical High $87.10 | Professional | None | $22.91 | $33.88 | $87.10 |
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 $16.22 Median $16.98 Typical High $22.91 | Professional | 52 · Reduced service | $16.22 | $16.98 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.76 Typical High $9.12 | Professional | 53 · Discontinued | $6.46 | $6.76 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $5.01 Typical High $6.92 | Professional | 55 · Aftercare only | $4.90 | $5.01 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.39 Typical High $4.57 | Professional | 56 · Pre-op care only | $3.24 | $3.39 | $4.57 |
Where Georgia sits
The same service costs 2.9 times more in Hawaii than in Delaware. 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· 16th of 51
$56.23
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.