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 $52.48 Median $52.48 Typical High $74.13 | Facility | None | $52.48 | $52.48 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $69.18 | Professional | None | $52.48 | $52.48 | $69.18 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $102.33 | Professional | None | $89.13 | $89.13 | $102.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $112.20 Median $389.05 Typical High $416.87 | Facility | None | $112.20 | $389.05 | $416.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $97.72 Typical High $363.08 | Professional | None | $53.70 | $97.72 | $363.08 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.25 Median $12.02 Typical High $53.70 | Professional | RR · Rental | $5.25 | $12.02 | $53.70 |
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 $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
CareSource Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $151.36 | Professional | None | $45.71 | $45.71 | $151.36 |
Kaiser Permanente Setting Professional Modifier None Typical Low $79.43 Median $112.20 Typical High $169.82 | Professional | None | $79.43 | $112.20 | $169.82 |
United Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $58.88 | Facility | None | $56.23 | $56.23 | $58.88 |
United Setting Professional Modifier None Typical Low $36.31 Median $54.95 Typical High $141.25 | Professional | None | $36.31 | $54.95 | $141.25 |
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 $26.30 Median $26.30 Typical High $34.67 | Professional | 52 · Reduced service | $26.30 | $26.30 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $10.47 Typical High $13.80 | Professional | 53 · Discontinued | $10.47 | $10.47 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $7.76 Typical High $10.47 | Professional | 55 · Aftercare only | $7.76 | $7.76 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.25 Typical High $6.92 | Professional | 56 · Pre-op care only | $5.25 | $5.25 | $6.92 |
Where Georgia sits
The same service costs 3.2 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· 5th of 51
$91.20
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.