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 $77.62 Median $77.62 Typical High $109.65 | Facility | None | $77.62 | $77.62 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $81.28 Typical High $104.71 | Professional | None | $77.62 | $81.28 | $104.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $165.96 Median $575.44 Typical High $616.60 | Facility | None | $165.96 | $575.44 | $616.60 |
Anthem BCBS Setting Professional Modifier None Typical Low $91.20 Median $144.54 Typical High $537.03 | Professional | None | $91.20 | $144.54 | $537.03 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $9.33 Median $20.42 Typical High $93.33 | Professional | RR · Rental | $9.33 | $20.42 | $93.33 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $70.79 Median $154.88 Typical High $707.95 | Professional | UE · Used equipment | $70.79 | $154.88 | $707.95 |
CareSource Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
CareSource Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $125.89 | Facility | None | $117.49 | $117.49 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $223.87 | Professional | None | $85.11 | $85.11 | $223.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $117.49 Median $165.96 Typical High $234.42 | Professional | None | $117.49 | $165.96 | $234.42 |
United Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
United Setting Professional Modifier None Typical Low $53.70 Median $81.28 Typical High $208.93 | Professional | None | $53.70 | $81.28 | $208.93 |
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 $38.90 Median $39.81 Typical High $51.29 | Professional | 52 · Reduced service | $38.90 | $39.81 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $15.85 Typical High $20.42 | Professional | 53 · Discontinued | $15.49 | $15.85 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $12.02 Typical High $15.49 | Professional | 55 · Aftercare only | $11.48 | $12.02 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.94 Typical High $10.23 | Professional | 56 · Pre-op care only | $7.76 | $7.94 | $10.23 |
Where Georgia sits
The same service costs 2.4 times more in Hawaii than in Colorado. 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· 15th of 51
$135
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.