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 $16.98 Median $16.98 Typical High $23.44 | Facility | None | $16.98 | $16.98 | $23.44 |
Aetna Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $22.39 | Professional | None | $16.98 | $16.98 | $22.39 |
Anthem BCBS Setting Facility Modifier None Typical Low $36.31 Median $125.89 Typical High $131.83 | Facility | None | $36.31 | $125.89 | $131.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $18.62 Median $31.62 Typical High $194.98 | Professional | None | $18.62 | $31.62 | $194.98 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.82 Median $4.27 Typical High $19.50 | Professional | RR · Rental | $1.82 | $4.27 | $19.50 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $13.80 Median $32.36 Typical High $147.91 | Professional | UE · Used equipment | $13.80 | $32.36 | $147.91 |
CareSource Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Facility | None | $30.20 | $30.20 | $30.20 |
CareSource Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Cigna Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $48.98 | Professional | None | $17.78 | $17.78 | $48.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $25.12 Median $36.31 Typical High $51.29 | Professional | None | $25.12 | $36.31 | $51.29 |
United Setting Professional Modifier None Typical Low $11.75 Median $17.78 Typical High $45.71 | Professional | None | $11.75 | $17.78 | $45.71 |
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 $8.51 Median $8.51 Typical High $11.22 | Professional | 52 · Reduced service | $8.51 | $8.51 | $11.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.39 Median $3.39 Typical High $4.47 | Professional | 53 · Discontinued | $3.39 | $3.39 | $4.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $2.51 Typical High $3.39 | Professional | 55 · Aftercare only | $2.51 | $2.51 | $3.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.70 Median $1.70 Typical High $2.24 | Professional | 56 · Pre-op care only | $1.70 | $1.70 | $2.24 |
Where Georgia sits
The same service costs 2.1 times more in Montana than in West Virginia. 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
$29.51
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.