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 $21.88 Median $21.88 Typical High $30.90 | Facility | None | $21.88 | $21.88 | $30.90 |
Aetna Setting Professional Modifier None Typical Low $21.88 Median $22.39 Typical High $29.51 | Professional | None | $21.88 | $22.39 | $29.51 |
Anthem BCBS Setting Facility Modifier None Typical Low $46.77 Median $162.18 Typical High $173.78 | Facility | None | $46.77 | $162.18 | $173.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $23.99 Median $38.02 Typical High $131.83 | Professional | None | $23.99 | $38.02 | $131.83 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.45 Median $5.62 Typical High $25.70 | Professional | RR · Rental | $2.45 | $5.62 | $25.70 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $18.20 Median $41.69 Typical High $190.55 | Professional | UE · Used equipment | $18.20 | $41.69 | $190.55 |
CareSource Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
CareSource Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | None | $38.90 | $38.90 | $38.90 |
Cigna Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Facility | None | $26.92 | $26.92 | $26.92 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $63.10 | Professional | None | $19.95 | $19.95 | $63.10 |
Kaiser Permanente Setting Professional Modifier None Typical Low $27.54 Median $46.77 Typical High $66.07 | Professional | None | $27.54 | $46.77 | $66.07 |
United Setting Professional Modifier None Typical Low $15.49 Median $22.91 Typical High $58.88 | Professional | None | $15.49 | $22.91 | $58.88 |
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 $10.96 Median $11.22 Typical High $14.79 | Professional | 52 · Reduced service | $10.96 | $11.22 | $14.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $4.47 Typical High $5.89 | Professional | 53 · Discontinued | $4.37 | $4.47 | $5.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.31 Median $3.31 Typical High $4.37 | Professional | 55 · Aftercare only | $3.31 | $3.31 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.24 Typical High $2.95 | Professional | 56 · Pre-op care only | $2.19 | $2.24 | $2.95 |
Where Georgia sits
The same service costs 2.5 times more in Montana than in Delaware. 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· 16th of 51
$33.88
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.