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 $53.70 Median $53.70 Typical High $74.13 | Facility | None | $53.70 | $53.70 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $54.95 Typical High $70.79 | Professional | None | $53.70 | $54.95 | $70.79 |
Ambetter Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $114.82 Median $398.11 Typical High $416.87 | Facility | None | $114.82 | $398.11 | $416.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $63.10 Median $100.00 Typical High $426.58 | Professional | None | $63.10 | $100.00 | $426.58 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.46 Median $14.79 Typical High $66.07 | Professional | RR · Rental | $6.46 | $14.79 | $66.07 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $47.86 Median $109.65 Typical High $501.19 | Professional | UE · Used equipment | $47.86 | $109.65 | $501.19 |
CareSource Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
CareSource Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $154.88 | Professional | None | $54.95 | $54.95 | $154.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $79.43 Median $114.82 Typical High $204.17 | Professional | None | $79.43 | $114.82 | $204.17 |
United Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $72.44 | Facility | None | $69.18 | $69.18 | $72.44 |
United Setting Professional Modifier None Typical Low $37.15 Median $56.23 Typical High $144.54 | Professional | None | $37.15 | $56.23 | $144.54 |
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 $26.92 Median $27.54 Typical High $35.48 | Professional | 52 · Reduced service | $26.92 | $27.54 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $11.22 Typical High $14.13 | Professional | 53 · Discontinued | $10.72 | $11.22 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $8.32 Typical High $10.72 | Professional | 55 · Aftercare only | $7.94 | $8.32 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.62 Typical High $7.08 | Professional | 56 · Pre-op care only | $5.37 | $5.62 | $7.08 |
Where Georgia sits
The same service costs 3.1 times more in Hawaii than in New Jersey. 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
$93.33
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.