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 $91.20 Median $91.20 Typical High $128.82 | Facility | None | $91.20 | $91.20 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $93.33 Typical High $123.03 | Professional | None | $91.20 | $93.33 | $123.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $199.53 Median $691.83 Typical High $724.44 | Facility | None | $199.53 | $691.83 | $724.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $173.78 Typical High $1,071.52 | Professional | None | $100.00 | $173.78 | $1,071.52 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $10.00 Median $23.44 Typical High $107.15 | Professional | RR · Rental | $10.00 | $23.44 | $107.15 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $75.86 Median $177.83 Typical High $794.33 | Professional | UE · Used equipment | $75.86 | $177.83 | $794.33 |
CareSource Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
CareSource Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $263.03 | Professional | None | $79.43 | $79.43 | $263.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $120.23 Median $199.53 Typical High $281.84 | Professional | None | $120.23 | $199.53 | $281.84 |
United Setting Professional Modifier None Typical Low $64.57 Median $97.72 Typical High $251.19 | Professional | None | $64.57 | $97.72 | $251.19 |
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 $45.71 Median $46.77 Typical High $61.66 | Professional | 52 · Reduced service | $45.71 | $46.77 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $24.55 | Professional | 53 · Discontinued | $18.62 | $18.62 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $14.13 Typical High $18.62 | Professional | 55 · Aftercare only | $13.80 | $14.13 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.33 Typical High $12.30 | Professional | 56 · Pre-op care only | $9.12 | $9.33 | $12.30 |
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
$162
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.