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 $97.72 Median $97.72 Typical High $138.04 | Facility | None | $97.72 | $97.72 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $131.83 | Professional | None | $97.72 | $97.72 | $131.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $208.93 Median $724.44 Typical High $776.25 | Facility | None | $208.93 | $724.44 | $776.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $181.97 Typical High $676.08 | Professional | None | $100.00 | $181.97 | $676.08 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $10.00 Median $22.91 Typical High $104.71 | Professional | RR · Rental | $10.00 | $22.91 | $104.71 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $74.13 Median $173.78 Typical High $794.33 | Professional | UE · Used equipment | $74.13 | $173.78 | $794.33 |
CareSource Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
CareSource Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $281.84 | Professional | None | $87.10 | $87.10 | $281.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $147.91 Median $208.93 Typical High $295.12 | Professional | None | $147.91 | $208.93 | $295.12 |
United Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $85.11 | Facility | None | $72.44 | $72.44 | $85.11 |
United Setting Professional Modifier None Typical Low $69.18 Median $102.33 Typical High $263.03 | Professional | None | $69.18 | $102.33 | $263.03 |
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 $48.98 Median $48.98 Typical High $64.57 | Professional | 52 · Reduced service | $48.98 | $48.98 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $19.50 Typical High $26.30 | Professional | 53 · Discontinued | $19.50 | $19.50 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $19.50 | Professional | 55 · Aftercare only | $14.79 | $14.79 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $9.77 Typical High $13.18 | Professional | 56 · Pre-op care only | $9.77 | $9.77 | $13.18 |
Where Georgia sits
The same service costs 2.4 times more in Montana than in Vermont. 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· 10th of 51
$170
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.