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 $42.66 Median $42.66 Typical High $58.88 | Facility | None | $42.66 | $42.66 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $47.86 Typical High $109.65 | Professional | None | $42.66 | $47.86 | $109.65 |
Ambetter Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $91.20 Median $316.23 Typical High $331.13 | Facility | None | $91.20 | $316.23 | $331.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $47.86 Median $79.43 Typical High $489.78 | Professional | None | $47.86 | $79.43 | $489.78 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.68 Median $10.72 Typical High $48.98 | Professional | RR · Rental | $4.68 | $10.72 | $48.98 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $34.67 Median $67.61 Typical High $371.54 | Professional | UE · Used equipment | $34.67 | $67.61 | $371.54 |
CareSource Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
CareSource Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $123.03 | Professional | None | $36.31 | $36.31 | $123.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $28.84 Median $91.20 Typical High $128.82 | Professional | None | $28.84 | $91.20 | $128.82 |
United Setting Professional Modifier None Typical Low $29.51 Median $44.67 Typical High $114.82 | Professional | None | $29.51 | $44.67 | $114.82 |
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 $21.38 Median $21.38 Typical High $28.18 | Professional | 52 · Reduced service | $21.38 | $21.38 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.51 Typical High $11.22 | Professional | 53 · Discontinued | $8.51 | $8.51 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.46 Typical High $8.51 | Professional | 55 · Aftercare only | $6.31 | $6.46 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $5.62 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $5.62 |
Where Georgia sits
The same service costs 3.0 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· 13th of 51
$74.13
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.