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 $74.13 Median $74.13 Typical High $102.33 | Facility | None | $74.13 | $74.13 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $93.33 Typical High $194.98 | Professional | None | $74.13 | $93.33 | $194.98 |
Ambetter Setting Professional Modifier None Typical Low $54.95 Median $70.79 Typical High $229.09 | Professional | None | $54.95 | $70.79 | $229.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $158.49 Median $549.54 Typical High $575.44 | Facility | None | $158.49 | $549.54 | $575.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $85.11 Median $138.04 Typical High $512.86 | Professional | None | $85.11 | $138.04 | $512.86 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.13 Median $18.62 Typical High $83.18 | Professional | RR · Rental | $8.13 | $18.62 | $83.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $61.66 Median $138.04 Typical High $630.96 | Professional | UE · Used equipment | $61.66 | $138.04 | $630.96 |
CareSource Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
CareSource Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $213.80 | Professional | None | $63.10 | $63.10 | $213.80 |
Cigna Setting Professional Modifier RR · Rental Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | RR · Rental | $8.71 | $8.71 | $8.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $109.65 Median $158.49 Typical High $223.87 | Professional | None | $109.65 | $158.49 | $223.87 |
Oscar Health Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,621.81 | $1,621.81 | $1,621.81 |
United Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $120.23 | Facility | None | $91.20 | $91.20 | $120.23 |
United Setting Professional Modifier None Typical Low $51.29 Median $77.62 Typical High $199.53 | Professional | None | $51.29 | $77.62 | $199.53 |
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 $37.15 Median $37.15 Typical High $48.98 | Professional | 52 · Reduced service | $37.15 | $37.15 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $14.79 Typical High $19.50 | Professional | 53 · Discontinued | $14.79 | $14.79 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $10.96 Typical High $14.79 | Professional | 55 · Aftercare only | $10.96 | $10.96 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.41 Typical High $9.77 | Professional | 56 · Pre-op care only | $7.41 | $7.41 | $9.77 |
Where Georgia sits
The same service costs 5.0 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· 11th of 51
$129
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.