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 $12.88 Median $12.88 Typical High $15.85 | Facility | None | $12.88 | $12.88 | $15.85 |
Aetna Setting Professional Modifier None Typical Low $11.48 Median $12.88 Typical High $15.14 | Professional | None | $11.48 | $12.88 | $15.14 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.22 Median $35.48 Typical High $54.95 | Professional | None | $16.22 | $35.48 | $54.95 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.37 Median $5.50 Typical High $5.75 | Professional | RR · Rental | $4.37 | $5.50 | $5.75 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $33.11 Median $40.74 Typical High $40.74 | Professional | UE · Used equipment | $33.11 | $40.74 | $40.74 |
CareSource Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Facility | None | $28.18 | $28.18 | $28.18 |
Cigna Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $28.18 | Professional | None | $20.42 | $20.42 | $28.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $23.44 Median $37.15 Typical High $123.03 | Professional | None | $23.44 | $37.15 | $123.03 |
Oscar Health Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $28.18 | Professional | None | $24.55 | $24.55 | $28.18 |
United Setting Professional Modifier None Typical Low $9.33 Median $14.79 Typical High $28.18 | Professional | None | $9.33 | $14.79 | $28.18 |
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 $5.75 Median $6.46 Typical High $7.59 | Professional | 52 · Reduced service | $5.75 | $6.46 | $7.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $2.57 Typical High $3.02 | Professional | 53 · Discontinued | $2.29 | $2.57 | $3.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.74 Median $1.95 Typical High $2.29 | Professional | 55 · Aftercare only | $1.74 | $1.95 | $2.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.15 Median $1.29 Typical High $1.51 | Professional | 56 · Pre-op care only | $1.15 | $1.29 | $1.51 |
Where Georgia sits
The same service costs 8.7 times more in Hawaii 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· 19th of 51
$22.39
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.