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 $141.25 Median $141.25 Typical High $194.98 | Facility | None | $141.25 | $141.25 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $141.25 Typical High $190.55 | Professional | None | $131.83 | $141.25 | $190.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $251.19 Median $870.96 Typical High $933.25 | Facility | None | $251.19 | $870.96 | $933.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $181.97 Median $239.88 Typical High $891.25 | Professional | None | $181.97 | $239.88 | $891.25 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $19.95 Median $26.30 Typical High $107.15 | Professional | RR · Rental | $19.95 | $26.30 | $107.15 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $147.91 Median $190.55 Typical High $812.83 | Professional | UE · Used equipment | $147.91 | $190.55 | $812.83 |
CareSource Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
CareSource Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $331.13 | Professional | None | $158.49 | $158.49 | $331.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $204.17 Median $251.19 Typical High $489.78 | Professional | None | $204.17 | $251.19 | $489.78 |
Oscar Health Setting Professional Modifier None Typical Low $245.47 Median $331.13 Typical High $407.38 | Professional | None | $245.47 | $331.13 | $407.38 |
United Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $234.42 | Facility | None | $213.80 | $213.80 | $234.42 |
United Setting Professional Modifier None Typical Low $107.15 Median $162.18 Typical High $309.03 | Professional | None | $107.15 | $162.18 | $309.03 |
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 $66.07 Median $70.79 Typical High $95.50 | Professional | 52 · Reduced service | $66.07 | $70.79 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $28.18 Typical High $38.02 | Professional | 53 · Discontinued | $26.30 | $28.18 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $20.89 Typical High $28.84 | Professional | 55 · Aftercare only | $19.95 | $20.89 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $14.13 Typical High $19.05 | Professional | 56 · Pre-op care only | $13.18 | $14.13 | $19.05 |
Where Georgia sits
The same service costs 2.9 times more in Hawaii than in Utah. 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· 9th of 51
$234
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.