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 $165.96 Median $165.96 Typical High $229.09 | Facility | None | $165.96 | $165.96 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $169.82 Typical High $218.78 | Professional | None | $165.96 | $169.82 | $218.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $354.81 Median $1,230.27 Typical High $1,288.25 | Facility | None | $354.81 | $1,230.27 | $1,288.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $190.55 Median $288.40 Typical High $1,000.00 | Professional | None | $190.55 | $288.40 | $1,000.00 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $20.89 Median $46.77 Typical High $213.80 | Professional | RR · Rental | $20.89 | $46.77 | $213.80 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $158.49 Median $354.81 Typical High $1,621.81 | Professional | UE · Used equipment | $158.49 | $354.81 | $1,621.81 |
CareSource Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
CareSource Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $467.74 | Professional | None | $158.49 | $158.49 | $467.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $245.47 Median $354.81 Typical High $537.03 | Professional | None | $245.47 | $354.81 | $537.03 |
United Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $257.04 | Facility | None | $229.09 | $229.09 | $257.04 |
United Setting Professional Modifier None Typical Low $117.49 Median $173.78 Typical High $446.68 | Professional | None | $117.49 | $173.78 | $446.68 |
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 $81.28 Median $85.11 Typical High $109.65 | Professional | 52 · Reduced service | $81.28 | $85.11 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $33.88 Typical High $43.65 | Professional | 53 · Discontinued | $33.11 | $33.88 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $25.70 Typical High $33.11 | Professional | 55 · Aftercare only | $24.55 | $25.70 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $16.98 Typical High $21.88 | Professional | 56 · Pre-op care only | $16.60 | $16.98 | $21.88 |
Where Georgia sits
The same service costs 4.4 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· 18th of 51
$251
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.