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 $66.07 Median $66.07 Typical High $93.33 | Facility | None | $66.07 | $66.07 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $67.61 Typical High $87.10 | Professional | None | $66.07 | $67.61 | $87.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $141.25 Median $489.78 Typical High $524.81 | Facility | None | $141.25 | $489.78 | $524.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $77.62 Median $114.82 Typical High $398.11 | Professional | None | $77.62 | $114.82 | $398.11 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.51 Median $19.05 Typical High $85.11 | Professional | RR · Rental | $8.51 | $19.05 | $85.11 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $63.10 Median $141.25 Typical High $645.65 | Professional | UE · Used equipment | $63.10 | $141.25 | $645.65 |
CareSource Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
CareSource Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $190.55 | Professional | None | $66.07 | $66.07 | $190.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $100.00 Median $141.25 Typical High $213.80 | Professional | None | $100.00 | $141.25 | $213.80 |
United Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $114.82 | Facility | None | $93.33 | $93.33 | $114.82 |
United Setting Professional Modifier None Typical Low $46.77 Median $69.18 Typical High $177.83 | Professional | None | $46.77 | $69.18 | $177.83 |
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 $33.11 Median $33.88 Typical High $43.65 | Professional | 52 · Reduced service | $33.11 | $33.88 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $13.49 Typical High $17.38 | Professional | 53 · Discontinued | $13.18 | $13.49 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $10.23 Typical High $13.18 | Professional | 55 · Aftercare only | $9.77 | $10.23 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.76 Typical High $8.71 | Professional | 56 · Pre-op care only | $6.61 | $6.76 | $8.71 |
Where Georgia sits
The same service costs 5.1 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· 18th of 51
$102
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.