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 $31.62 Median $31.62 Typical High $43.65 | Facility | None | $31.62 | $31.62 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $41.69 | Professional | None | $31.62 | $31.62 | $41.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $67.61 Median $234.42 Typical High $245.47 | Facility | None | $67.61 | $234.42 | $245.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $34.67 Median $54.95 Typical High $190.55 | Professional | None | $34.67 | $54.95 | $190.55 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.47 Median $7.94 Typical High $36.31 | Professional | RR · Rental | $3.47 | $7.94 | $36.31 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $25.70 Median $60.26 Typical High $275.42 | Professional | UE · Used equipment | $25.70 | $60.26 | $275.42 |
CareSource Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
CareSource Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $91.20 | Professional | None | $26.92 | $26.92 | $91.20 |
Kaiser Permanente Setting Professional Modifier None Typical Low $46.77 Median $67.61 Typical High $95.50 | Professional | None | $46.77 | $67.61 | $95.50 |
United Setting Professional Modifier None Typical Low $21.88 Median $33.11 Typical High $85.11 | Professional | None | $21.88 | $33.11 | $85.11 |
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 $15.85 Median $15.85 Typical High $20.89 | Professional | 52 · Reduced service | $15.85 | $15.85 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.31 Typical High $8.32 | Professional | 53 · Discontinued | $6.31 | $6.31 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $4.79 Typical High $6.31 | Professional | 55 · Aftercare only | $4.68 | $4.79 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.16 Typical High $4.17 | Professional | 56 · Pre-op care only | $3.16 | $3.16 | $4.17 |
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· 16th of 51
$52.48
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.