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 $123.03 Median $123.03 Typical High $173.78 | Facility | None | $123.03 | $123.03 | $173.78 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $128.82 Typical High $173.78 | Professional | None | $123.03 | $128.82 | $173.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $263.03 Median $912.01 Typical High $977.24 | Facility | None | $263.03 | $912.01 | $977.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $144.54 Median $229.09 Typical High $851.14 | Professional | None | $144.54 | $229.09 | $851.14 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $15.49 Median $34.67 Typical High $158.49 | Professional | RR · Rental | $15.49 | $34.67 | $158.49 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $117.49 Median $263.03 Typical High $1,202.26 | Professional | UE · Used equipment | $117.49 | $263.03 | $1,202.26 |
CareSource Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
CareSource Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $354.81 | Professional | None | $117.49 | $117.49 | $354.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $186.21 Median $263.03 Typical High $398.11 | Professional | None | $186.21 | $263.03 | $398.11 |
United Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $169.82 | Facility | None | $141.25 | $141.25 | $169.82 |
United Setting Professional Modifier None Typical Low $87.10 Median $128.82 Typical High $331.13 | Professional | None | $87.10 | $128.82 | $331.13 |
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 $61.66 Median $64.57 Typical High $87.10 | Professional | 52 · Reduced service | $61.66 | $64.57 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $25.70 Typical High $34.67 | Professional | 53 · Discontinued | $24.55 | $25.70 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $19.50 Typical High $26.30 | Professional | 55 · Aftercare only | $18.62 | $19.50 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.88 Typical High $17.38 | Professional | 56 · Pre-op care only | $12.30 | $12.88 | $17.38 |
Where Georgia sits
The same service costs 4.4 times more in Hawaii than in Kansas. 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
$219
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.