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 $35.48 Median $35.48 Typical High $50.12 | Facility | None | $35.48 | $35.48 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $35.48 Median $36.31 Typical High $47.86 | Professional | None | $35.48 | $36.31 | $47.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $77.62 Median $269.15 Typical High $281.84 | Facility | None | $77.62 | $269.15 | $281.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $40.74 Median $67.61 Typical High $416.87 | Professional | None | $40.74 | $67.61 | $416.87 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.07 Median $9.12 Typical High $41.69 | Professional | RR · Rental | $4.07 | $9.12 | $41.69 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $30.90 Median $57.54 Typical High $309.03 | Professional | UE · Used equipment | $30.90 | $57.54 | $309.03 |
CareSource Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
CareSource Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $102.33 | Professional | None | $30.90 | $30.90 | $102.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $53.70 Median $77.62 Typical High $109.65 | Professional | None | $53.70 | $77.62 | $109.65 |
United Setting Professional Modifier None Typical Low $25.12 Median $38.02 Typical High $95.50 | Professional | None | $25.12 | $38.02 | $95.50 |
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 $17.78 Median $18.20 Typical High $23.99 | Professional | 52 · Reduced service | $17.78 | $18.20 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.24 Typical High $9.55 | Professional | 53 · Discontinued | $7.24 | $7.24 | $9.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $5.37 Typical High $7.24 | Professional | 55 · Aftercare only | $5.37 | $5.37 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $3.63 Typical High $4.79 | Professional | 56 · Pre-op care only | $3.55 | $3.63 | $4.79 |
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
$63.10
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.