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 $70.79 | Professional | None | $52.48 | $52.48 | $70.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $114.82 Median $389.05 Typical High $416.87 | Facility | None | $114.82 | $389.05 | $416.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $97.72 Typical High $371.54 | Professional | None | $53.70 | $97.72 | $371.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.25 Median $11.75 Typical High $53.70 | Professional | RR · Rental | $5.25 | $11.75 | $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 $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 $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $151.36 | Professional | None | $46.77 | $46.77 | $151.36 |
Kaiser Permanente Setting Professional Modifier None Typical Low $79.43 Median $114.82 Typical High $169.82 | Professional | None | $79.43 | $114.82 | $169.82 |
United Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $60.26 | Facility | None | $57.54 | $57.54 | $60.26 |
United Setting Professional Modifier None Typical Low $37.15 Median $54.95 Typical High $141.25 | Professional | None | $37.15 | $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 $35.48 | Professional | 52 · Reduced service | $26.30 | $26.30 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $10.47 Typical High $14.13 | Professional | 53 · Discontinued | $10.47 | $10.47 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $7.94 Typical High $10.47 | Professional | 55 · Aftercare only | $7.94 | $7.94 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.25 Typical High $7.08 | Professional | 56 · Pre-op care only | $5.25 | $5.25 | $7.08 |
Where Georgia sits
The same service costs 3.5 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
$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.