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 $54.95 Median $54.95 Typical High $75.86 | Facility | None | $54.95 | $54.95 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $72.44 | Professional | None | $54.95 | $54.95 | $72.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $117.49 Median $407.38 Typical High $426.58 | Facility | None | $117.49 | $407.38 | $426.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $102.33 Typical High $436.52 | Professional | None | $53.70 | $102.33 | $436.52 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.25 Median $12.02 Typical High $54.95 | Professional | RR · Rental | $5.25 | $12.02 | $54.95 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $39.81 Median $89.13 Typical High $407.38 | Professional | UE · Used equipment | $39.81 | $89.13 | $407.38 |
CareSource Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
CareSource Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $158.49 | Professional | None | $48.98 | $48.98 | $158.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $81.28 Median $117.49 Typical High $169.82 | Professional | None | $81.28 | $117.49 | $169.82 |
United Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $58.88 | Facility | None | $47.86 | $47.86 | $58.88 |
United Setting Professional Modifier None Typical Low $38.02 Median $57.54 Typical High $147.91 | Professional | None | $38.02 | $57.54 | $147.91 |
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 $27.54 Median $27.54 Typical High $36.31 | Professional | 52 · Reduced service | $27.54 | $27.54 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $10.96 Typical High $14.45 | Professional | 53 · Discontinued | $10.96 | $10.96 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.13 Typical High $10.96 | Professional | 55 · Aftercare only | $8.13 | $8.13 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.50 Typical High $7.24 | Professional | 56 · Pre-op care only | $5.50 | $5.50 | $7.24 |
Where Georgia sits
The same service costs 3.4 times more in Hawaii than in Vermont. 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
$95.50
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.