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 $251.19 Median $251.19 Typical High $354.81 | Facility | None | $251.19 | $251.19 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $263.03 Typical High $346.74 | Professional | None | $251.19 | $263.03 | $346.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $537.03 Median $1,862.09 Typical High $1,995.26 | Facility | None | $537.03 | $1,862.09 | $1,995.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $295.12 Median $436.52 Typical High $1,513.56 | Professional | None | $295.12 | $436.52 | $1,513.56 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $32.36 Median $72.44 Typical High $331.13 | Professional | RR · Rental | $32.36 | $72.44 | $331.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $239.88 Median $537.03 Typical High $2,454.71 | Professional | UE · Used equipment | $239.88 | $537.03 | $2,454.71 |
CareSource Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
CareSource Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $724.44 | Professional | None | $239.88 | $239.88 | $724.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $380.19 Median $537.03 Typical High $831.76 | Professional | None | $380.19 | $537.03 | $831.76 |
Oscar Health Setting Professional Modifier None Typical Low $549.54 Median $758.58 Typical High $1,148.15 | Professional | None | $549.54 | $758.58 | $1,148.15 |
United Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $363.08 | Facility | None | $354.81 | $354.81 | $363.08 |
United Setting Professional Modifier None Typical Low $177.83 Median $263.03 Typical High $676.08 | Professional | None | $177.83 | $263.03 | $676.08 |
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 $125.89 Median $131.83 Typical High $165.96 | Professional | 52 · Reduced service | $125.89 | $131.83 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $52.48 Typical High $67.61 | Professional | 53 · Discontinued | $50.12 | $52.48 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $38.90 Typical High $50.12 | Professional | 55 · Aftercare only | $38.02 | $38.90 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $26.30 Typical High $33.88 | Professional | 56 · Pre-op care only | $25.12 | $26.30 | $33.88 |
Where Georgia sits
The same service costs 4.1 times more in Hawaii than in Florida. 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· 18th of 51
$389
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.