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 $69.18 Median $69.18 Typical High $97.72 | Facility | None | $69.18 | $69.18 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $85.11 Typical High $97.72 | Professional | None | $69.18 | $85.11 | $97.72 |
Ambetter Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $112.20 | Professional | None | $75.86 | $75.86 | $112.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $151.36 Median $524.81 Typical High $549.54 | Facility | None | $151.36 | $524.81 | $549.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $83.18 Median $131.83 Typical High $489.78 | Professional | None | $83.18 | $131.83 | $489.78 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.51 Median $19.05 Typical High $87.10 | Professional | RR · Rental | $8.51 | $19.05 | $87.10 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $63.10 Median $144.54 Typical High $660.69 | Professional | UE · Used equipment | $63.10 | $144.54 | $660.69 |
CareSource Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
CareSource Setting Professional Modifier None Typical Low $125.89 Median $190.55 Typical High $234.42 | Professional | None | $125.89 | $190.55 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $199.53 | Professional | None | $74.13 | $74.13 | $199.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $104.71 Median $151.36 Typical High $213.80 | Professional | None | $104.71 | $151.36 | $213.80 |
United Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
United Setting Professional Modifier None Typical Low $48.98 Median $74.13 Typical High $186.21 | Professional | None | $48.98 | $74.13 | $186.21 |
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 $34.67 Median $35.48 Typical High $46.77 | Professional | 52 · Reduced service | $34.67 | $35.48 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.13 Typical High $18.62 | Professional | 53 · Discontinued | $14.13 | $14.13 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.72 Typical High $14.13 | Professional | 55 · Aftercare only | $10.47 | $10.72 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $7.08 Typical High $9.33 | Professional | 56 · Pre-op care only | $6.92 | $7.08 | $9.33 |
Where Georgia sits
The same service costs 2.9 times more in Hawaii than in New Jersey. 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
$117
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.