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 $83.18 Median $83.18 Typical High $117.49 | Facility | None | $83.18 | $83.18 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $87.10 Typical High $112.20 | Professional | None | $83.18 | $87.10 | $112.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $177.83 Median $616.60 Typical High $660.69 | Facility | None | $177.83 | $616.60 | $660.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $97.72 Median $154.88 Typical High $1,096.48 | Professional | None | $97.72 | $154.88 | $1,096.48 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $10.72 Median $23.99 Typical High $109.65 | Professional | RR · Rental | $10.72 | $23.99 | $109.65 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $81.28 Median $177.83 Typical High $812.83 | Professional | UE · Used equipment | $81.28 | $177.83 | $812.83 |
CareSource Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
CareSource Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $239.88 | Professional | None | $81.28 | $81.28 | $239.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $125.89 Median $177.83 Typical High $275.42 | Professional | None | $125.89 | $177.83 | $275.42 |
United Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $107.15 | Facility | None | $89.13 | $89.13 | $107.15 |
United Setting Professional Modifier None Typical Low $60.26 Median $87.10 Typical High $223.87 | Professional | None | $60.26 | $87.10 | $223.87 |
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 $41.69 Median $43.65 Typical High $56.23 | Professional | 52 · Reduced service | $41.69 | $43.65 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $17.38 Typical High $22.39 | Professional | 53 · Discontinued | $16.60 | $17.38 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.88 Typical High $16.60 | Professional | 55 · Aftercare only | $12.59 | $12.88 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.71 Typical High $11.22 | Professional | 56 · Pre-op care only | $8.32 | $8.71 | $11.22 |
Where Georgia sits
The same service costs 3.0 times more in Montana 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· 13th of 51
$148
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.