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 $75.86 Median $75.86 Typical High $104.71 | Facility | None | $75.86 | $75.86 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $77.62 Typical High $100.00 | Professional | None | $75.86 | $77.62 | $100.00 |
Ambetter Setting Professional Modifier None Typical Low $128.82 Median $208.93 Typical High $208.93 | Professional | None | $128.82 | $208.93 | $208.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $162.18 Median $562.34 Typical High $588.84 | Facility | None | $162.18 | $562.34 | $588.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $87.10 Median $141.25 Typical High $524.81 | Professional | None | $87.10 | $141.25 | $524.81 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.51 Median $19.05 Typical High $87.10 | Professional | RR · Rental | $8.51 | $19.05 | $87.10 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $63.10 Median $144.54 Typical High $660.69 | Professional | UE · Used equipment | $63.10 | $144.54 | $660.69 |
CareSource Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
CareSource Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $218.78 | Professional | None | $64.57 | $64.57 | $218.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $112.20 Median $162.18 Typical High $229.09 | Professional | None | $112.20 | $162.18 | $229.09 |
United Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
United Setting Professional Modifier None Typical Low $52.48 Median $79.43 Typical High $204.17 | Professional | None | $52.48 | $79.43 | $204.17 |
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 $38.02 Median $38.02 Typical High $50.12 | Professional | 52 · Reduced service | $38.02 | $38.02 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $19.95 | Professional | 53 · Discontinued | $15.14 | $15.14 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.48 Typical High $15.14 | Professional | 55 · Aftercare only | $11.22 | $11.48 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $10.00 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $10.00 |
Where Georgia sits
The same service costs 2.8 times more in Kansas 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· 14th of 51
$132
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.