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 $25.12 Median $25.12 Typical High $34.67 | Facility | None | $25.12 | $25.12 | $34.67 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $25.70 Typical High $33.11 | Professional | None | $25.12 | $25.70 | $33.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $53.70 Median $186.21 Typical High $194.98 | Facility | None | $53.70 | $186.21 | $194.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $27.54 Median $46.77 Typical High $288.40 | Professional | None | $27.54 | $46.77 | $288.40 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.75 Median $6.31 Typical High $28.84 | Professional | RR · Rental | $2.75 | $6.31 | $28.84 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $20.42 Median $47.86 Typical High $218.78 | Professional | UE · Used equipment | $20.42 | $47.86 | $218.78 |
CareSource Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Facility | None | $44.67 | $44.67 | $44.67 |
CareSource Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Facility | None | $34.67 | $34.67 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $70.79 | Professional | None | $25.70 | $25.70 | $70.79 |
Kaiser Permanente Setting Professional Modifier None Typical Low $37.15 Median $53.70 Typical High $75.86 | Professional | None | $37.15 | $53.70 | $75.86 |
United Setting Professional Modifier None Typical Low $17.38 Median $26.30 Typical High $67.61 | Professional | None | $17.38 | $26.30 | $67.61 |
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 $12.30 Median $12.59 Typical High $16.60 | Professional | 52 · Reduced service | $12.30 | $12.59 | $16.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $5.01 Typical High $6.61 | Professional | 53 · Discontinued | $5.01 | $5.01 | $6.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.80 Typical High $5.01 | Professional | 55 · Aftercare only | $3.72 | $3.80 | $5.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $2.51 Typical High $3.31 | Professional | 56 · Pre-op care only | $2.51 | $2.51 | $3.31 |
Where Georgia sits
The same service costs 2.1 times more in Montana than in New Jersey. 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
$43.65
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.