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 $125.89 Median $125.89 Typical High $177.83 | Facility | None | $125.89 | $125.89 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $131.83 Typical High $177.83 | Professional | None | $125.89 | $131.83 | $177.83 |
Ambetter Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $269.15 Median $933.25 Typical High $1,000.00 | Facility | None | $269.15 | $933.25 | $1,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $128.82 Median $234.42 Typical High $870.96 | Professional | None | $128.82 | $234.42 | $870.96 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $12.59 Median $36.31 Typical High $165.96 | Professional | RR · Rental | $12.59 | $36.31 | $165.96 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $93.33 Median $269.15 Typical High $1,230.27 | Professional | UE · Used equipment | $93.33 | $269.15 | $1,230.27 |
CareSource Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
CareSource Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $190.55 | Facility | None | $177.83 | $177.83 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $363.08 | Professional | None | $128.82 | $128.82 | $363.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $190.55 Median $269.15 Typical High $389.05 | Professional | None | $190.55 | $269.15 | $389.05 |
United Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $186.21 | Facility | None | $177.83 | $177.83 | $186.21 |
United Setting Professional Modifier None Typical Low $89.13 Median $131.83 Typical High $338.84 | Professional | None | $89.13 | $131.83 | $338.84 |
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 $63.10 Median $66.07 Typical High $87.10 | Professional | 52 · Reduced service | $63.10 | $66.07 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $26.30 Typical High $35.48 | Professional | 53 · Discontinued | $25.12 | $26.30 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.95 Typical High $26.30 | Professional | 55 · Aftercare only | $19.05 | $19.95 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $13.18 Typical High $17.78 | Professional | 56 · Pre-op care only | $12.59 | $13.18 | $17.78 |
Where Georgia sits
The same service costs 3.5 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· 17th of 51
$214
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.