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 $25.70 Median $25.70 Typical High $35.48 | Facility | None | $25.70 | $25.70 | $35.48 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $26.30 Typical High $33.88 | Professional | None | $25.70 | $26.30 | $33.88 |
Ambetter Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $43.65 | Professional | None | $21.38 | $21.38 | $43.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $54.95 Median $190.55 Typical High $199.53 | Facility | None | $54.95 | $190.55 | $199.53 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.20 Median $47.86 Typical High $331.13 | Professional | None | $30.20 | $47.86 | $331.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.24 Median $7.24 Typical High $33.11 | Professional | RR · Rental | $3.24 | $7.24 | $33.11 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $23.99 Median $54.95 Typical High $251.19 | Professional | UE · Used equipment | $23.99 | $54.95 | $251.19 |
CareSource Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
CareSource Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
Cigna Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $72.44 | Professional | None | $28.84 | $28.84 | $72.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $38.02 Median $54.95 Typical High $77.62 | Professional | None | $38.02 | $54.95 | $77.62 |
United Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $51.29 | Facility | None | $35.48 | $35.48 | $51.29 |
United Setting Professional Modifier None Typical Low $18.20 Median $26.92 Typical High $69.18 | Professional | None | $18.20 | $26.92 | $69.18 |
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 $12.59 Median $13.18 Typical High $16.98 | Professional | 52 · Reduced service | $12.59 | $13.18 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $5.25 Typical High $6.76 | Professional | 53 · Discontinued | $5.13 | $5.25 | $6.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $3.98 Typical High $5.13 | Professional | 55 · Aftercare only | $3.80 | $3.98 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $2.63 Typical High $3.39 | Professional | 56 · Pre-op care only | $2.51 | $2.63 | $3.39 |
Where Georgia sits
The same service costs 4.7 times more in Hawaii than in Florida. 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
$44.67
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.