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 $17.78 Median $17.78 Typical High $21.88 | Facility | None | $17.78 | $17.78 | $21.88 |
Aetna Setting Professional Modifier None Typical Low $15.85 Median $17.78 Typical High $20.89 | Professional | None | $15.85 | $17.78 | $20.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $22.39 Median $52.48 Typical High $67.61 | Professional | None | $22.39 | $52.48 | $67.61 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.37 Median $6.76 Typical High $7.08 | Professional | RR · Rental | $5.37 | $6.76 | $7.08 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $40.74 Median $51.29 Typical High $51.29 | Professional | UE · Used equipment | $40.74 | $51.29 | $51.29 |
CareSource Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
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 $54.95 | Professional | None | $39.81 | $39.81 | $54.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $32.36 Median $51.29 Typical High $100.00 | Professional | None | $32.36 | $51.29 | $100.00 |
Oscar Health Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $38.90 | Professional | None | $33.88 | $33.88 | $38.90 |
United Setting Professional Modifier None Typical Low $12.88 Median $20.42 Typical High $38.90 | Professional | None | $12.88 | $20.42 | $38.90 |
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 $7.94 Median $8.91 Typical High $10.47 | Professional | 52 · Reduced service | $7.94 | $8.91 | $10.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.16 Median $3.55 Typical High $4.17 | Professional | 53 · Discontinued | $3.16 | $3.55 | $4.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.40 Median $2.69 Typical High $3.16 | Professional | 55 · Aftercare only | $2.40 | $2.69 | $3.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.58 Median $1.78 Typical High $2.09 | Professional | 56 · Pre-op care only | $1.58 | $1.78 | $2.09 |
Where Georgia sits
The same service costs 8.9 times more in North Dakota than in Colorado. 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· 24th of 51
$38.90
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.