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 $144.54 Median $144.54 Typical High $199.53 | Facility | None | $144.54 | $144.54 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $147.91 Typical High $194.98 | Professional | None | $144.54 | $147.91 | $194.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $309.03 Median $1,071.52 Typical High $1,122.02 | Facility | None | $309.03 | $1,071.52 | $1,122.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $269.15 Typical High $1,862.09 | Professional | None | $169.82 | $269.15 | $1,862.09 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $18.20 Median $40.74 Typical High $186.21 | Professional | RR · Rental | $18.20 | $40.74 | $186.21 |
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 $257.04 Median $257.04 Typical High $257.04 | Facility | None | $257.04 | $257.04 | $257.04 |
CareSource Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $407.38 | Professional | None | $158.49 | $158.49 | $407.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $213.80 Median $309.03 Typical High $467.74 | Professional | None | $213.80 | $309.03 | $467.74 |
United Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $204.17 | Facility | None | $199.53 | $199.53 | $204.17 |
United Setting Professional Modifier None Typical Low $102.33 Median $151.36 Typical High $389.05 | Professional | None | $102.33 | $151.36 | $389.05 |
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 $70.79 Median $74.13 Typical High $95.50 | Professional | 52 · Reduced service | $70.79 | $74.13 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $29.51 Typical High $38.90 | Professional | 53 · Discontinued | $28.84 | $29.51 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $22.39 Typical High $28.84 | Professional | 55 · Aftercare only | $21.38 | $22.39 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.79 Typical High $19.50 | Professional | 56 · Pre-op care only | $14.45 | $14.79 | $19.50 |
Where Georgia sits
The same service costs 3.3 times more in Hawaii than in West Virginia. 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· 15th of 51
$251
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.