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 $19.95 Median $19.95 Typical High $27.54 | Facility | None | $19.95 | $19.95 | $27.54 |
Aetna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $26.30 | Professional | None | $19.95 | $19.95 | $26.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $42.66 Median $147.91 Typical High $154.88 | Facility | None | $42.66 | $147.91 | $154.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $14.79 Median $37.15 Typical High $229.09 | Professional | None | $14.79 | $37.15 | $229.09 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.02 Median $5.01 Typical High $22.91 | Professional | RR · Rental | $3.02 | $5.01 | $22.91 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $10.00 Median $38.02 Typical High $173.78 | Professional | UE · Used equipment | $10.00 | $38.02 | $173.78 |
CareSource Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
CareSource Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
Cigna Setting Facility Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Facility | None | $22.91 | $22.91 | $22.91 |
Cigna Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $56.23 | Professional | None | $16.98 | $16.98 | $56.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $29.51 Median $42.66 Typical High $60.26 | Professional | None | $29.51 | $42.66 | $60.26 |
United Setting Professional Modifier None Typical Low $13.80 Median $20.89 Typical High $53.70 | Professional | None | $13.80 | $20.89 | $53.70 |
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 $9.77 Median $10.00 Typical High $13.18 | Professional | 52 · Reduced service | $9.77 | $10.00 | $13.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.98 Median $3.98 Typical High $5.25 | Professional | 53 · Discontinued | $3.98 | $3.98 | $5.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.95 Median $3.02 Typical High $3.98 | Professional | 55 · Aftercare only | $2.95 | $3.02 | $3.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $2.00 Typical High $2.63 | Professional | 56 · Pre-op care only | $1.95 | $2.00 | $2.63 |
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
$34.67
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.