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 $181.97 Median $181.97 Typical High $251.19 | Facility | None | $181.97 | $181.97 | $251.19 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $229.09 Typical High $478.63 | Professional | None | $181.97 | $229.09 | $478.63 |
Ambetter Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $1,348.96 Typical High $1,412.54 | Facility | None | $389.05 | $1,348.96 | $1,412.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $64.57 Median $275.42 Typical High $1,445.44 | Professional | None | $64.57 | $275.42 | $1,445.44 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $21.88 Median $45.71 Typical High $208.93 | Professional | RR · Rental | $21.88 | $45.71 | $208.93 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $165.96 Median $346.74 Typical High $1,584.89 | Professional | UE · Used equipment | $165.96 | $346.74 | $1,584.89 |
CareSource Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Facility | None | $323.59 | $323.59 | $323.59 |
CareSource Setting Professional Modifier None Typical Low $323.59 Median $489.78 Typical High $602.56 | Professional | None | $323.59 | $489.78 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $524.81 | Professional | None | $154.88 | $154.88 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $269.15 Median $389.05 Typical High $549.54 | Professional | None | $269.15 | $389.05 | $549.54 |
United Setting Professional Modifier None Typical Low $125.89 Median $190.55 Typical High $489.78 | Professional | None | $125.89 | $190.55 | $489.78 |
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 $91.20 Median $91.20 Typical High $120.23 | Professional | 52 · Reduced service | $91.20 | $91.20 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $47.86 | Professional | 53 · Discontinued | $36.31 | $36.31 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $27.54 Typical High $36.31 | Professional | 55 · Aftercare only | $26.92 | $27.54 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $23.99 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $23.99 |
Where Georgia sits
The same service costs 2.4 times more in Hawaii 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· 19th 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.