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 $93.33 Median $93.33 Typical High $131.83 | Facility | None | $93.33 | $93.33 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $123.03 | Professional | None | $93.33 | $93.33 | $123.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $199.53 Median $691.83 Typical High $724.44 | Facility | None | $199.53 | $691.83 | $724.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $64.57 Median $138.04 Typical High $562.34 | Professional | None | $64.57 | $138.04 | $562.34 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.48 Median $23.44 Typical High $107.15 | Professional | RR · Rental | $11.48 | $23.44 | $107.15 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $85.11 Median $177.83 Typical High $812.83 | Professional | UE · Used equipment | $85.11 | $177.83 | $812.83 |
CareSource Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
CareSource Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $269.15 | Professional | None | $95.50 | $95.50 | $269.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $199.53 Typical High $281.84 | Professional | None | $141.25 | $199.53 | $281.84 |
United Setting Professional Modifier None Typical Low $64.57 Median $97.72 Typical High $251.19 | Professional | None | $64.57 | $97.72 | $251.19 |
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 $46.77 Median $46.77 Typical High $61.66 | Professional | 52 · Reduced service | $46.77 | $46.77 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $24.55 | Professional | 53 · Discontinued | $18.62 | $18.62 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $14.13 Typical High $18.62 | Professional | 55 · Aftercare only | $13.80 | $14.13 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.33 Typical High $12.30 | Professional | 56 · Pre-op care only | $9.33 | $9.33 | $12.30 |
Where Georgia sits
The same service costs 2.5 times more in Kansas than in Utah. 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· 21st of 51
$129
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.