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 $29.51 Median $29.51 Typical High $40.74 | Facility | None | $29.51 | $29.51 | $40.74 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $36.31 Typical High $77.62 | Professional | None | $29.51 | $36.31 | $77.62 |
Ambetter Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $63.10 Median $218.78 Typical High $229.09 | Facility | None | $63.10 | $218.78 | $229.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $34.67 Median $54.95 Typical High $338.84 | Professional | None | $34.67 | $54.95 | $338.84 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.31 Median $7.41 Typical High $33.88 | Professional | RR · Rental | $3.31 | $7.41 | $33.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $25.12 Median $56.23 Typical High $257.04 | Professional | UE · Used equipment | $25.12 | $56.23 | $257.04 |
CareSource Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
CareSource Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $36.31 | Facility | None | $33.88 | $33.88 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $85.11 | Professional | None | $25.12 | $25.12 | $85.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $43.65 Median $63.10 Typical High $89.13 | Professional | None | $43.65 | $63.10 | $89.13 |
United Setting Professional Modifier None Typical Low $20.42 Median $30.90 Typical High $79.43 | Professional | None | $20.42 | $30.90 | $79.43 |
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 $14.79 Median $14.79 Typical High $19.50 | Professional | 52 · Reduced service | $14.79 | $14.79 | $19.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $5.89 Typical High $7.76 | Professional | 53 · Discontinued | $5.89 | $5.89 | $7.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.47 Typical High $5.89 | Professional | 55 · Aftercare only | $4.37 | $4.47 | $5.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $2.95 Typical High $3.89 | Professional | 56 · Pre-op care only | $2.95 | $2.95 | $3.89 |
Where Georgia sits
The same service costs 2.8 times more in Montana than in Kansas. 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
$51.29
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.