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 $50.12 Median $50.12 Typical High $70.79 | Facility | None | $50.12 | $50.12 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $67.61 | Professional | None | $50.12 | $50.12 | $67.61 |
Anthem BCBS Setting Facility Modifier None Typical Low $107.15 Median $371.54 Typical High $398.11 | Facility | None | $107.15 | $371.54 | $398.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $56.23 Median $87.10 Typical High $302.00 | Professional | None | $56.23 | $87.10 | $302.00 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.62 Median $12.88 Typical High $57.54 | Professional | RR · Rental | $5.62 | $12.88 | $57.54 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $42.66 Median $95.50 Typical High $436.52 | Professional | UE · Used equipment | $42.66 | $95.50 | $436.52 |
CareSource Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
CareSource Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $144.54 | Professional | None | $50.12 | $50.12 | $144.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $75.86 Median $107.15 Typical High $151.36 | Professional | None | $75.86 | $107.15 | $151.36 |
United Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $60.26 | Facility | None | $32.36 | $32.36 | $60.26 |
United Setting Professional Modifier None Typical Low $35.48 Median $52.48 Typical High $134.90 | Professional | None | $35.48 | $52.48 | $134.90 |
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 $25.12 Median $25.12 Typical High $33.11 | Professional | 52 · Reduced service | $25.12 | $25.12 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.23 Typical High $13.49 | Professional | 53 · Discontinued | $10.00 | $10.23 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.59 Typical High $10.00 | Professional | 55 · Aftercare only | $7.59 | $7.59 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.13 Typical High $6.76 | Professional | 56 · Pre-op care only | $5.01 | $5.13 | $6.76 |
Where Georgia sits
The same service costs 2.1 times more in Montana 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· 16th of 51
$77.62
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.