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 $36.31 Median $36.31 Typical High $51.29 | Facility | None | $36.31 | $36.31 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $37.15 Typical High $51.29 | Professional | None | $36.31 | $37.15 | $51.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $77.62 Median $269.15 Typical High $288.40 | Facility | None | $77.62 | $269.15 | $288.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $42.66 Median $67.61 Typical High $467.74 | Professional | None | $42.66 | $67.61 | $467.74 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.57 Median $10.47 Typical High $46.77 | Professional | RR · Rental | $4.57 | $10.47 | $46.77 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $33.88 Median $77.62 Typical High $354.81 | Professional | UE · Used equipment | $33.88 | $77.62 | $354.81 |
CareSource Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
CareSource Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $104.71 | Professional | None | $39.81 | $39.81 | $104.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $54.95 Median $77.62 Typical High $109.65 | Professional | None | $54.95 | $77.62 | $109.65 |
Oscar Health Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $102.33 | Professional | None | $89.13 | $89.13 | $102.33 |
United Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
United Setting Professional Modifier None Typical Low $25.70 Median $38.02 Typical High $97.72 | Professional | None | $25.70 | $38.02 | $97.72 |
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 $18.20 Median $18.62 Typical High $25.12 | Professional | 52 · Reduced service | $18.20 | $18.62 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.41 Typical High $10.23 | Professional | 53 · Discontinued | $7.24 | $7.41 | $10.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $5.62 Typical High $7.59 | Professional | 55 · Aftercare only | $5.37 | $5.62 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.72 Typical High $5.13 | Professional | 56 · Pre-op care only | $3.63 | $3.72 | $5.13 |
Where Georgia sits
The same service costs 3.5 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· 17th of 51
$63.10
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.