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 $23.44 Median $23.44 Typical High $33.11 | Facility | None | $23.44 | $23.44 | $33.11 |
Aetna Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $30.90 | Professional | None | $23.44 | $23.44 | $30.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $50.12 Median $173.78 Typical High $186.21 | Facility | None | $50.12 | $173.78 | $186.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.92 Median $43.65 Typical High $269.15 | Professional | None | $26.92 | $43.65 | $269.15 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.69 Median $6.03 Typical High $26.92 | Professional | RR · Rental | $2.69 | $6.03 | $26.92 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $19.95 Median $38.02 Typical High $204.17 | Professional | UE · Used equipment | $19.95 | $38.02 | $204.17 |
CareSource Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
CareSource Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
Cigna Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Facility | None | $27.54 | $27.54 | $27.54 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $67.61 | Professional | None | $19.95 | $19.95 | $67.61 |
Kaiser Permanente Setting Professional Modifier None Typical Low $27.54 Median $50.12 Typical High $70.79 | Professional | None | $27.54 | $50.12 | $70.79 |
United Setting Professional Modifier None Typical Low $16.22 Median $24.55 Typical High $63.10 | Professional | None | $16.22 | $24.55 | $63.10 |
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 $11.75 Median $11.75 Typical High $15.49 | Professional | 52 · Reduced service | $11.75 | $11.75 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.68 Median $4.68 Typical High $6.31 | Professional | 53 · Discontinued | $4.68 | $4.68 | $6.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.55 Median $3.55 Typical High $4.68 | Professional | 55 · Aftercare only | $3.55 | $3.55 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.34 Median $2.34 Typical High $3.09 | Professional | 56 · Pre-op care only | $2.34 | $2.34 | $3.09 |
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
$40.74
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.