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 $37.15 Median $37.15 Typical High $52.48 | Facility | None | $37.15 | $37.15 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $38.02 Typical High $50.12 | Professional | None | $37.15 | $38.02 | $50.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $79.43 Median $275.42 Typical High $295.12 | Facility | None | $79.43 | $275.42 | $295.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $42.66 Median $69.18 Typical High $275.42 | Professional | None | $42.66 | $69.18 | $275.42 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.27 Median $9.55 Typical High $43.65 | Professional | RR · Rental | $4.27 | $9.55 | $43.65 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $31.62 Median $70.79 Typical High $323.59 | Professional | UE · Used equipment | $31.62 | $70.79 | $323.59 |
CareSource Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
CareSource Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | None | $66.07 | $66.07 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $107.15 | Professional | None | $31.62 | $31.62 | $107.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $56.23 Median $79.43 Typical High $112.20 | Professional | None | $56.23 | $79.43 | $112.20 |
United Setting Professional Modifier None Typical Low $26.30 Median $38.90 Typical High $100.00 | Professional | None | $26.30 | $38.90 | $100.00 |
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 $18.62 Median $19.05 Typical High $25.12 | Professional | 52 · Reduced service | $18.62 | $19.05 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $7.59 Typical High $10.00 | Professional | 53 · Discontinued | $7.41 | $7.59 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.62 Typical High $7.41 | Professional | 55 · Aftercare only | $5.62 | $5.62 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $3.80 Typical High $5.01 | Professional | 56 · Pre-op care only | $3.72 | $3.80 | $5.01 |
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· 12th of 51
$66.07
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.