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 $114.82 Median $114.82 Typical High $158.49 | Facility | None | $114.82 | $114.82 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $144.54 Typical High $263.03 | Professional | None | $114.82 | $144.54 | $263.03 |
Ambetter Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $245.47 Median $851.14 Typical High $891.25 | Facility | None | $245.47 | $851.14 | $891.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $64.57 Median $186.21 Typical High $794.33 | Professional | None | $64.57 | $186.21 | $794.33 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.48 Median $28.84 Typical High $131.83 | Professional | RR · Rental | $11.48 | $28.84 | $131.83 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $85.11 Median $218.78 Typical High $1,000.00 | Professional | UE · Used equipment | $85.11 | $218.78 | $1,000.00 |
CareSource Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
CareSource Setting Professional Modifier None Typical Low $204.17 Median $309.03 Typical High $380.19 | Professional | None | $204.17 | $309.03 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $154.88 | Facility | None | $151.36 | $151.36 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $331.13 | Professional | None | $112.20 | $112.20 | $331.13 |
Cigna Setting Professional Modifier RR · Rental Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | RR · Rental | $15.14 | $15.14 | $15.14 |
Kaiser Permanente Setting Professional Modifier None Typical Low $169.82 Median $245.47 Typical High $380.19 | Professional | None | $169.82 | $245.47 | $380.19 |
United Setting Professional Modifier None Typical Low $79.43 Median $120.23 Typical High $309.03 | Professional | None | $79.43 | $120.23 | $309.03 |
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 $57.54 Median $57.54 Typical High $75.86 | Professional | 52 · Reduced service | $57.54 | $57.54 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $22.91 Typical High $30.20 | Professional | 53 · Discontinued | $22.91 | $22.91 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $17.38 Typical High $22.91 | Professional | 55 · Aftercare only | $16.98 | $17.38 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $15.14 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $15.14 |
Where Georgia sits
The same service costs 2.1 times more in Hawaii 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
$158
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.