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 $69.18 Median $69.18 Typical High $97.72 | Facility | None | $69.18 | $69.18 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $87.10 Typical High $181.97 | Professional | None | $69.18 | $87.10 | $181.97 |
Ambetter Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $151.36 | Professional | None | $75.86 | $75.86 | $151.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $147.91 Median $512.86 Typical High $549.54 | Facility | None | $147.91 | $512.86 | $549.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $69.18 Median $128.82 Typical High $478.63 | Professional | None | $69.18 | $128.82 | $478.63 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.76 Median $15.14 Typical High $69.18 | Professional | RR · Rental | $6.76 | $15.14 | $69.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $51.29 Median $112.20 Typical High $512.86 | Professional | UE · Used equipment | $51.29 | $112.20 | $512.86 |
CareSource Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
CareSource Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $199.53 | Professional | None | $64.57 | $64.57 | $199.53 |
Cigna Setting Professional Modifier RR · Rental Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | RR · Rental | $8.91 | $8.91 | $8.91 |
Kaiser Permanente Setting Professional Modifier None Typical Low $104.71 Median $147.91 Typical High $213.80 | Professional | None | $104.71 | $147.91 | $213.80 |
Oscar Health Setting Professional Modifier None Typical Low $125.89 Median $194.98 Typical High $213.80 | Professional | None | $125.89 | $194.98 | $213.80 |
United Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $75.86 | Facility | None | $72.44 | $72.44 | $75.86 |
United Setting Professional Modifier None Typical Low $48.98 Median $72.44 Typical High $186.21 | Professional | None | $48.98 | $72.44 | $186.21 |
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 $34.67 Median $34.67 Typical High $46.77 | Professional | 52 · Reduced service | $34.67 | $34.67 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $18.62 | Professional | 53 · Discontinued | $13.80 | $13.80 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.47 Typical High $13.80 | Professional | 55 · Aftercare only | $10.47 | $10.47 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $9.33 | Professional | 56 · Pre-op care only | $6.92 | $6.92 | $9.33 |
Where Georgia sits
The same service costs 2.8 times more in Hawaii than in Washington, DC. 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· 4th of 51
$123
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.