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 $18.20 Median $18.20 Typical High $25.70 | Facility | None | $18.20 | $18.20 | $25.70 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $18.62 Typical High $24.55 | Professional | None | $18.20 | $18.62 | $24.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $38.90 Median $134.90 Typical High $144.54 | Facility | None | $38.90 | $134.90 | $144.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $20.89 Median $33.88 Typical High $213.80 | Professional | None | $20.89 | $33.88 | $213.80 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.09 Median $4.68 Typical High $21.38 | Professional | RR · Rental | $2.09 | $4.68 | $21.38 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $15.49 Median $34.67 Typical High $158.49 | Professional | UE · Used equipment | $15.49 | $34.67 | $158.49 |
CareSource Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Facility | None | $32.36 | $32.36 | $32.36 |
CareSource Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
Cigna Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Facility | None | $25.70 | $25.70 | $25.70 |
Cigna Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $52.48 | Professional | None | $18.62 | $18.62 | $52.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $18.62 Median $38.90 Typical High $54.95 | Professional | None | $18.62 | $38.90 | $54.95 |
United Setting Professional Modifier None Typical Low $12.88 Median $19.05 Typical High $48.98 | Professional | None | $12.88 | $19.05 | $48.98 |
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 $9.12 Median $9.33 Typical High $12.30 | Professional | 52 · Reduced service | $9.12 | $9.33 | $12.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $3.72 Typical High $4.90 | Professional | 53 · Discontinued | $3.63 | $3.72 | $4.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $2.75 Typical High $3.63 | Professional | 55 · Aftercare only | $2.75 | $2.75 | $3.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $1.86 Typical High $2.45 | Professional | 56 · Pre-op care only | $1.82 | $1.86 | $2.45 |
Where Georgia sits
The same service costs 2.2 times more in Montana than in New Jersey. 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· 12th of 51
$32.36
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.