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 $323.59 Median $323.59 Typical High $457.09 | Facility | None | $323.59 | $323.59 | $457.09 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $389.05 Typical High $676.08 | Professional | None | $323.59 | $389.05 | $676.08 |
Ambetter Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $2,398.83 Typical High $2,570.40 | Facility | None | $691.83 | $2,398.83 | $2,570.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $602.56 Typical High $2,238.72 | Professional | None | $380.19 | $602.56 | $2,238.72 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $39.81 Median $83.18 Typical High $371.54 | Professional | RR · Rental | $39.81 | $83.18 | $371.54 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $295.12 Median $616.60 Typical High $2,818.38 | Professional | UE · Used equipment | $295.12 | $616.60 | $2,818.38 |
CareSource Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Facility | None | $575.44 | $575.44 | $575.44 |
CareSource Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $933.25 | Professional | None | $309.03 | $309.03 | $933.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $489.78 Median $691.83 Typical High $977.24 | Professional | None | $489.78 | $691.83 | $977.24 |
Oscar Health Setting Professional Modifier None Typical Low $691.83 Median $954.99 Typical High $1,479.11 | Professional | None | $691.83 | $954.99 | $1,479.11 |
United Setting Professional Modifier None Typical Low $229.09 Median $338.84 Typical High $870.96 | Professional | None | $229.09 | $338.84 | $870.96 |
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 $162.18 Median $162.18 Typical High $213.80 | Professional | 52 · Reduced service | $162.18 | $162.18 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $66.07 Typical High $87.10 | Professional | 53 · Discontinued | $64.57 | $66.07 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $64.57 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $43.65 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $43.65 |
Where Georgia sits
The same service costs 2.2 times more in Montana 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
$562
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.