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 $60.26 Median $60.26 Typical High $85.11 | Facility | None | $60.26 | $60.26 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $63.10 Typical High $83.18 | Professional | None | $60.26 | $63.10 | $83.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $128.82 Median $446.68 Typical High $478.63 | Facility | None | $128.82 | $446.68 | $478.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $70.79 Median $112.20 Typical High $489.78 | Professional | None | $70.79 | $112.20 | $489.78 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $7.59 Median $17.38 Typical High $79.43 | Professional | RR · Rental | $7.59 | $17.38 | $79.43 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $57.54 Median $128.82 Typical High $588.84 | Professional | UE · Used equipment | $57.54 | $128.82 | $588.84 |
CareSource Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
CareSource Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $173.78 | Professional | None | $75.86 | $75.86 | $173.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $91.20 Median $128.82 Typical High $199.53 | Professional | None | $91.20 | $128.82 | $199.53 |
United Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $85.11 | Facility | None | $75.86 | $75.86 | $85.11 |
United Setting Professional Modifier None Typical Low $42.66 Median $63.10 Typical High $162.18 | Professional | None | $42.66 | $63.10 | $162.18 |
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 $30.20 Median $31.62 Typical High $40.74 | Professional | 52 · Reduced service | $30.20 | $31.62 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.59 Typical High $16.60 | Professional | 53 · Discontinued | $12.02 | $12.59 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.33 Typical High $12.30 | Professional | 55 · Aftercare only | $9.12 | $9.33 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.31 Typical High $8.32 | Professional | 56 · Pre-op care only | $6.03 | $6.31 | $8.32 |
Where Georgia sits
The same service costs 3.0 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· 14th of 51
$105
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.