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 $60.26 Median $60.26 Typical High $85.11 | Facility | None | $60.26 | $60.26 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $61.66 Typical High $81.28 | Professional | None | $60.26 | $61.66 | $81.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $131.83 Median $446.68 Typical High $478.63 | Facility | None | $131.83 | $446.68 | $478.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $66.07 Median $112.20 Typical High $707.95 | Professional | None | $66.07 | $112.20 | $707.95 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.61 Median $15.49 Typical High $70.79 | Professional | RR · Rental | $6.61 | $15.49 | $70.79 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $50.12 Median $114.82 Typical High $524.81 | Professional | UE · Used equipment | $50.12 | $114.82 | $524.81 |
CareSource Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
CareSource Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $173.78 | Professional | None | $51.29 | $51.29 | $173.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $66.07 Median $131.83 Typical High $186.21 | Professional | None | $66.07 | $131.83 | $186.21 |
United Setting Professional Modifier None Typical Low $42.66 Median $63.10 Typical High $162.18 | Professional | None | $42.66 | $63.10 | $162.18 |
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 $30.20 Median $30.90 Typical High $40.74 | Professional | 52 · Reduced service | $30.20 | $30.90 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.30 Typical High $16.22 | Professional | 53 · Discontinued | $12.02 | $12.30 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.12 Typical High $12.02 | Professional | 55 · Aftercare only | $9.12 | $9.12 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.17 Typical High $8.13 | Professional | 56 · Pre-op care only | $6.03 | $6.17 | $8.13 |
Where Georgia sits
The same service costs 2.6 times more in Hawaii 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
$107
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.