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 $131.83 Median $131.83 Typical High $181.97 | Facility | None | $131.83 | $131.83 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $169.82 Typical High $346.74 | Professional | None | $131.83 | $169.82 | $346.74 |
Ambetter Setting Professional Modifier None Typical Low $112.20 Median $208.93 Typical High $537.03 | Professional | None | $112.20 | $208.93 | $537.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $281.84 Median $977.24 Typical High $1,023.29 | Facility | None | $281.84 | $977.24 | $1,023.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $245.47 Typical High $794.33 | Professional | None | $158.49 | $245.47 | $794.33 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $15.85 Median $29.51 Typical High $151.36 | Professional | RR · Rental | $15.85 | $29.51 | $151.36 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $117.49 Median $208.93 Typical High $1,148.15 | Professional | UE · Used equipment | $117.49 | $208.93 | $1,148.15 |
CareSource Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
CareSource Setting Professional Modifier None Typical Low $234.42 Median $354.81 Typical High $436.52 | Professional | None | $234.42 | $354.81 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $144.54 | Facility | None | $141.25 | $141.25 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $380.19 | Professional | None | $104.71 | $104.71 | $380.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $194.98 Median $281.84 Typical High $575.44 | Professional | None | $194.98 | $281.84 | $575.44 |
Oscar Health Setting Facility Modifier None Typical Low $1,288.25 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,288.25 | $1,819.70 | $1,819.70 |
Oscar Health Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $588.84 | Professional | None | $281.84 | $389.05 | $588.84 |
United Setting Professional Modifier None Typical Low $91.20 Median $138.04 Typical High $354.81 | Professional | None | $91.20 | $138.04 | $354.81 |
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 $66.07 Median $66.07 Typical High $87.10 | Professional | 52 · Reduced service | $66.07 | $66.07 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $26.30 Typical High $34.67 | Professional | 53 · Discontinued | $26.30 | $26.30 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.95 Typical High $26.30 | Professional | 55 · Aftercare only | $19.50 | $19.95 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $17.38 | Professional | 56 · Pre-op care only | $13.18 | $13.18 | $17.38 |
Where Georgia sits
The same service costs 2.2 times more in Hawaii 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
$229
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.