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 $43.65 Median $43.65 Typical High $61.66 | Facility | None | $43.65 | $43.65 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $57.54 Typical High $114.82 | Professional | None | $43.65 | $57.54 | $114.82 |
Ambetter Setting Professional Modifier None Typical Low $30.20 Median $102.33 Typical High $154.88 | Professional | None | $30.20 | $102.33 | $154.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $93.33 Median $323.59 Typical High $346.74 | Facility | None | $93.33 | $323.59 | $346.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $51.29 Median $81.28 Typical High $562.34 | Professional | None | $51.29 | $81.28 | $562.34 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.50 Median $12.30 Typical High $56.23 | Professional | RR · Rental | $5.50 | $12.30 | $56.23 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $40.74 Median $91.20 Typical High $416.87 | Professional | UE · Used equipment | $40.74 | $91.20 | $416.87 |
CareSource Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
CareSource Setting Professional Modifier None Typical Low $79.43 Median $120.23 Typical High $147.91 | Professional | None | $79.43 | $120.23 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $125.89 | Professional | None | $42.66 | $42.66 | $125.89 |
Cigna Setting Professional Modifier RR · Rental Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | RR · Rental | $5.75 | $5.75 | $5.75 |
Kaiser Permanente Setting Professional Modifier None Typical Low $66.07 Median $93.33 Typical High $134.90 | Professional | None | $66.07 | $93.33 | $134.90 |
Oscar Health Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $123.03 | Facility | None | $74.13 | $74.13 | $123.03 |
Oscar Health Setting Professional Modifier None Typical Low $97.72 Median $128.82 Typical High $194.98 | Professional | None | $97.72 | $128.82 | $194.98 |
United Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $51.29 | Facility | None | $43.65 | $43.65 | $51.29 |
United Setting Professional Modifier None Typical Low $30.90 Median $45.71 Typical High $117.49 | Professional | None | $30.90 | $45.71 | $117.49 |
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 $21.88 Median $22.91 Typical High $29.51 | Professional | 52 · Reduced service | $21.88 | $22.91 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $9.12 Typical High $11.75 | Professional | 53 · Discontinued | $8.71 | $9.12 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.76 Typical High $8.71 | Professional | 55 · Aftercare only | $6.61 | $6.76 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.57 Typical High $5.89 | Professional | 56 · Pre-op care only | $4.37 | $4.57 | $5.89 |
Where Georgia sits
The same service costs 2.6 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· 16th of 51
$77.62
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.