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 $54.95 Median $54.95 Typical High $77.62 | Facility | None | $54.95 | $54.95 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $56.23 Typical High $74.13 | Professional | None | $54.95 | $56.23 | $74.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $117.49 Median $407.38 Typical High $436.52 | Facility | None | $117.49 | $407.38 | $436.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $102.33 Typical High $338.84 | Professional | None | $67.61 | $102.33 | $338.84 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.61 Median $11.75 Typical High $64.57 | Professional | RR · Rental | $6.61 | $11.75 | $64.57 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $50.12 Median $89.13 Typical High $478.63 | Professional | UE · Used equipment | $50.12 | $89.13 | $478.63 |
CareSource Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
CareSource Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $158.49 | Professional | None | $51.29 | $51.29 | $158.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $83.18 Median $117.49 Typical High $177.83 | Professional | None | $83.18 | $117.49 | $177.83 |
United Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $63.10 | Facility | None | $57.54 | $57.54 | $63.10 |
United Setting Professional Modifier None Typical Low $38.90 Median $57.54 Typical High $147.91 | Professional | None | $38.90 | $57.54 | $147.91 |
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 $27.54 Median $28.18 Typical High $37.15 | Professional | 52 · Reduced service | $27.54 | $28.18 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $10.96 Typical High $14.79 | Professional | 53 · Discontinued | $10.96 | $10.96 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.32 Typical High $10.96 | Professional | 55 · Aftercare only | $8.32 | $8.32 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.62 Typical High $7.41 | Professional | 56 · Pre-op care only | $5.50 | $5.62 | $7.41 |
Where Georgia sits
The same service costs 2.4 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
$97.72
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.