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 $186.21 Median $186.21 Typical High $263.03 | Facility | None | $186.21 | $186.21 | $263.03 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $194.98 Typical High $263.03 | Professional | None | $186.21 | $194.98 | $263.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $398.11 Median $1,380.38 Typical High $1,479.11 | Facility | None | $398.11 | $1,380.38 | $1,479.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $331.13 Typical High $1,122.02 | Professional | None | $218.78 | $331.13 | $1,122.02 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $23.99 Median $53.70 Typical High $245.47 | Professional | RR · Rental | $23.99 | $53.70 | $245.47 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $181.97 Median $398.11 Typical High $1,819.70 | Professional | UE · Used equipment | $181.97 | $398.11 | $1,819.70 |
CareSource Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
CareSource Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $537.03 | Professional | None | $177.83 | $177.83 | $537.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $281.84 Median $398.11 Typical High $616.60 | Professional | None | $281.84 | $398.11 | $616.60 |
United Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $204.17 | Facility | None | $147.91 | $147.91 | $204.17 |
United Setting Professional Modifier None Typical Low $131.83 Median $194.98 Typical High $501.19 | Professional | None | $131.83 | $194.98 | $501.19 |
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 $93.33 Median $97.72 Typical High $131.83 | Professional | 52 · Reduced service | $93.33 | $97.72 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $38.90 Typical High $52.48 | Professional | 53 · Discontinued | $37.15 | $38.90 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.84 Typical High $39.81 | Professional | 55 · Aftercare only | $28.18 | $28.84 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $19.50 Typical High $26.30 | Professional | 56 · Pre-op care only | $18.62 | $19.50 | $26.30 |
Where Georgia sits
The same service costs 2.9 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· 19th of 51
$288
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.