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 $162.18 Median $162.18 Typical High $229.09 | Facility | None | $162.18 | $162.18 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $165.96 Typical High $213.80 | Professional | None | $162.18 | $165.96 | $213.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $346.74 Median $1,202.26 Typical High $1,288.25 | Facility | None | $346.74 | $1,202.26 | $1,288.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $186.21 Median $302.00 Typical High $1,288.25 | Professional | None | $186.21 | $302.00 | $1,288.25 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $18.62 Median $41.69 Typical High $190.55 | Professional | RR · Rental | $18.62 | $41.69 | $190.55 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $138.04 Median $309.03 Typical High $1,412.54 | Professional | UE · Used equipment | $138.04 | $309.03 | $1,412.54 |
CareSource Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Facility | None | $288.40 | $288.40 | $288.40 |
CareSource Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $467.74 | Professional | None | $138.04 | $138.04 | $467.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $245.47 Median $346.74 Typical High $489.78 | Professional | None | $245.47 | $346.74 | $489.78 |
Oscar Health Setting Professional Modifier None Typical Low $346.74 Median $457.09 Typical High $691.83 | Professional | None | $346.74 | $457.09 | $691.83 |
United Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $173.78 | Facility | None | $125.89 | $125.89 | $173.78 |
United Setting Professional Modifier None Typical Low $112.20 Median $169.82 Typical High $436.52 | Professional | None | $112.20 | $169.82 | $436.52 |
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 $81.28 Median $83.18 Typical High $107.15 | Professional | 52 · Reduced service | $81.28 | $83.18 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $33.88 Typical High $42.66 | Professional | 53 · Discontinued | $32.36 | $33.88 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $25.12 Typical High $32.36 | Professional | 55 · Aftercare only | $24.55 | $25.12 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.60 Typical High $21.38 | Professional | 56 · Pre-op care only | $16.22 | $16.60 | $21.38 |
Where Georgia sits
The same service costs 2.7 times more in Hawaii than in Delaware. 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· 13th of 51
$282
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.