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 $47.86 Median $47.86 Typical High $66.07 | Facility | None | $47.86 | $47.86 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $63.10 | Professional | None | $47.86 | $47.86 | $63.10 |
Ambetter Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $102.33 Median $354.81 Typical High $371.54 | Facility | None | $102.33 | $354.81 | $371.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $56.23 Median $89.13 Typical High $380.19 | Professional | None | $56.23 | $89.13 | $380.19 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.50 Median $12.59 Typical High $57.54 | Professional | RR · Rental | $5.50 | $12.59 | $57.54 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $41.69 Median $93.33 Typical High $426.58 | Professional | UE · Used equipment | $41.69 | $93.33 | $426.58 |
CareSource Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
CareSource Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $134.90 | Professional | None | $45.71 | $45.71 | $134.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $70.79 Median $102.33 Typical High $144.54 | Professional | None | $70.79 | $102.33 | $144.54 |
United Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $63.10 | Facility | None | $61.66 | $61.66 | $63.10 |
United Setting Professional Modifier None Typical Low $33.11 Median $50.12 Typical High $128.82 | Professional | None | $33.11 | $50.12 | $128.82 |
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 $23.44 Median $23.99 Typical High $31.62 | Professional | 52 · Reduced service | $23.44 | $23.99 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $9.55 Typical High $12.59 | Professional | 53 · Discontinued | $9.55 | $9.55 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.24 Typical High $9.55 | Professional | 55 · Aftercare only | $7.08 | $7.24 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $4.79 Typical High $6.31 | Professional | 56 · Pre-op care only | $4.79 | $4.79 | $6.31 |
Where Georgia sits
The same service costs 4.3 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· 14th of 51
$83.18
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.