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 $295.12 Median $295.12 Typical High $416.87 | Facility | None | $295.12 | $295.12 | $416.87 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $309.03 Typical High $407.38 | Professional | None | $295.12 | $309.03 | $407.38 |
Ambetter Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $478.63 | Professional | None | $323.59 | $323.59 | $478.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $2,187.76 Typical High $2,344.23 | Facility | None | $630.96 | $2,187.76 | $2,344.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $346.74 Median $549.54 Typical High $2,398.83 | Professional | None | $346.74 | $549.54 | $2,398.83 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $38.02 Median $85.11 Typical High $389.05 | Professional | RR · Rental | $38.02 | $85.11 | $389.05 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $281.84 Median $630.96 Typical High $2,884.03 | Professional | UE · Used equipment | $281.84 | $630.96 | $2,884.03 |
CareSource Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Facility | None | $524.81 | $524.81 | $524.81 |
CareSource Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Facility | None | $524.81 | $524.81 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $851.14 | Professional | None | $380.19 | $380.19 | $851.14 |
Cigna Setting Professional Modifier RR · Rental Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | RR · Rental | $52.48 | $52.48 | $52.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $446.68 Median $630.96 Typical High $912.01 | Professional | None | $446.68 | $630.96 | $912.01 |
United Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $416.87 | Facility | None | $389.05 | $389.05 | $416.87 |
United Setting Professional Modifier None Typical Low $208.93 Median $309.03 Typical High $794.33 | Professional | None | $208.93 | $309.03 | $794.33 |
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 $147.91 Median $154.88 Typical High $204.17 | Professional | 52 · Reduced service | $147.91 | $154.88 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $61.66 Typical High $81.28 | Professional | 53 · Discontinued | $58.88 | $61.66 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $46.77 Typical High $60.26 | Professional | 55 · Aftercare only | $44.67 | $46.77 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $30.90 Typical High $40.74 | Professional | 56 · Pre-op care only | $29.51 | $30.90 | $40.74 |
Where Georgia sits
The same service costs 2.8 times more in Hawaii than in Maryland. 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· 16th of 51
$525
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.