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 $46.77 Median $46.77 Typical High $66.07 | Facility | None | $46.77 | $46.77 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $47.86 Typical High $63.10 | Professional | None | $46.77 | $47.86 | $63.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $100.00 Median $346.74 Typical High $371.54 | Facility | None | $100.00 | $346.74 | $371.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $52.48 Median $81.28 Typical High $288.40 | Professional | None | $52.48 | $81.28 | $288.40 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.25 Median $12.02 Typical High $54.95 | Professional | RR · Rental | $5.25 | $12.02 | $54.95 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $39.81 Median $89.13 Typical High $407.38 | Professional | UE · Used equipment | $39.81 | $89.13 | $407.38 |
CareSource Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
CareSource Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $134.90 | Professional | None | $51.29 | $51.29 | $134.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $70.79 Median $100.00 Typical High $141.25 | Professional | None | $70.79 | $100.00 | $141.25 |
United Setting Professional Modifier None Typical Low $33.11 Median $48.98 Typical High $125.89 | Professional | None | $33.11 | $48.98 | $125.89 |
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 $23.44 Median $23.44 Typical High $30.90 | Professional | 52 · Reduced service | $23.44 | $23.44 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $9.55 Typical High $12.59 | Professional | 53 · Discontinued | $9.33 | $9.55 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.08 Typical High $9.33 | Professional | 55 · Aftercare only | $7.08 | $7.08 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $4.68 Typical High $6.31 | Professional | 56 · Pre-op care only | $4.68 | $4.68 | $6.31 |
Where Georgia sits
The same service costs 2.0 times more in Hawaii than in West Virginia. 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
$79.43
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.