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 $45.71 Median $45.71 Typical High $64.57 | Facility | None | $45.71 | $45.71 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $58.88 Typical High $120.23 | Professional | None | $45.71 | $58.88 | $120.23 |
Ambetter Setting Professional Modifier None Typical Low $38.02 Median $128.82 Typical High $186.21 | Professional | None | $38.02 | $128.82 | $186.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $97.72 Median $338.84 Typical High $363.08 | Facility | None | $97.72 | $338.84 | $363.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $57.54 Median $85.11 Typical High $275.42 | Professional | None | $57.54 | $85.11 | $275.42 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.62 Median $10.23 Typical High $58.88 | Professional | RR · Rental | $5.62 | $10.23 | $58.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $42.66 Median $74.13 Typical High $446.68 | Professional | UE · Used equipment | $42.66 | $74.13 | $446.68 |
CareSource Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
CareSource Setting Professional Modifier None Typical Low $81.28 Median $125.89 Typical High $154.88 | Professional | None | $81.28 | $125.89 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $61.66 Typical High $61.66 | Facility | None | $60.26 | $61.66 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $131.83 | Professional | None | $44.67 | $44.67 | $131.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $69.18 Median $97.72 Typical High $245.47 | Professional | None | $69.18 | $97.72 | $245.47 |
United Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
United Setting Professional Modifier None Typical Low $33.88 Median $48.98 Typical High $123.03 | Professional | None | $33.88 | $48.98 | $123.03 |
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 $22.91 Median $23.44 Typical High $30.90 | Professional | 52 · Reduced service | $22.91 | $23.44 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.33 Typical High $12.30 | Professional | 53 · Discontinued | $9.12 | $9.33 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $7.08 Typical High $9.12 | Professional | 55 · Aftercare only | $6.76 | $7.08 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.68 Typical High $6.17 | Professional | 56 · Pre-op care only | $4.57 | $4.68 | $6.17 |
Where Georgia sits
The same service costs 2.1 times more in Wisconsin 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· 17th of 51
$79.43
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.