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 $28.84 Median $28.84 Typical High $39.81 | Facility | None | $28.84 | $28.84 | $39.81 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $38.02 | Professional | None | $28.84 | $28.84 | $38.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $61.66 Median $213.80 Typical High $223.87 | Facility | None | $61.66 | $213.80 | $223.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.90 Median $53.70 Typical High $331.13 | Professional | None | $30.90 | $53.70 | $331.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.16 Median $7.24 Typical High $33.11 | Professional | RR · Rental | $3.16 | $7.24 | $33.11 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $23.44 Median $54.95 Typical High $245.47 | Professional | UE · Used equipment | $23.44 | $54.95 | $245.47 |
CareSource Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
CareSource Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | None | $51.29 | $51.29 | $51.29 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $81.28 | Professional | None | $24.55 | $24.55 | $81.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $38.02 Median $61.66 Typical High $87.10 | Professional | None | $38.02 | $61.66 | $87.10 |
United Setting Professional Modifier None Typical Low $19.95 Median $30.20 Typical High $77.62 | Professional | None | $19.95 | $30.20 | $77.62 |
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 $14.13 Median $14.45 Typical High $19.05 | Professional | 52 · Reduced service | $14.13 | $14.45 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $5.75 Typical High $7.59 | Professional | 53 · Discontinued | $5.75 | $5.75 | $7.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.37 Typical High $5.75 | Professional | 55 · Aftercare only | $4.27 | $4.37 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.88 Typical High $3.80 | Professional | 56 · Pre-op care only | $2.82 | $2.88 | $3.80 |
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· 14th of 51
$50.12
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.