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 $48.98 Median $48.98 Typical High $69.18 | Facility | None | $48.98 | $48.98 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $50.12 Typical High $66.07 | Professional | None | $48.98 | $50.12 | $66.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $104.71 Median $363.08 Typical High $389.05 | Facility | None | $104.71 | $363.08 | $389.05 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $91.20 Typical High $575.44 | Professional | None | $53.70 | $91.20 | $575.44 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.37 Median $12.59 Typical High $57.54 | Professional | RR · Rental | $5.37 | $12.59 | $57.54 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $40.74 Median $93.33 Typical High $426.58 | Professional | UE · Used equipment | $40.74 | $93.33 | $426.58 |
CareSource Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
CareSource Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $141.25 | Professional | None | $41.69 | $41.69 | $141.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $67.61 Median $104.71 Typical High $147.91 | Professional | None | $67.61 | $104.71 | $147.91 |
United Setting Professional Modifier None Typical Low $34.67 Median $51.29 Typical High $131.83 | Professional | None | $34.67 | $51.29 | $131.83 |
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 $24.55 Median $24.55 Typical High $32.36 | Professional | 52 · Reduced service | $24.55 | $24.55 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $10.00 Typical High $13.18 | Professional | 53 · Discontinued | $9.77 | $10.00 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.41 Typical High $9.77 | Professional | 55 · Aftercare only | $7.41 | $7.41 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $5.01 Typical High $6.61 | Professional | 56 · Pre-op care only | $4.90 | $5.01 | $6.61 |
Where Georgia sits
The same service costs 2.6 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· 13th of 51
$85.11
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.