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 $43.65 Median $43.65 Typical High $61.66 | Facility | None | $43.65 | $43.65 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $45.71 Typical High $61.66 | Professional | None | $43.65 | $45.71 | $61.66 |
Anthem BCBS Setting Facility Modifier None Typical Low $95.50 Median $331.13 Typical High $346.74 | Facility | None | $95.50 | $331.13 | $346.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $51.29 Median $83.18 Typical High $269.15 | Professional | None | $51.29 | $83.18 | $269.15 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.01 Median $9.55 Typical High $53.70 | Professional | RR · Rental | $5.01 | $9.55 | $53.70 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $38.02 Median $74.13 Typical High $398.11 | Professional | UE · Used equipment | $38.02 | $74.13 | $398.11 |
CareSource Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
CareSource Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $125.89 | Professional | None | $38.90 | $38.90 | $125.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $66.07 Median $95.50 Typical High $275.42 | Professional | None | $66.07 | $95.50 | $275.42 |
United Setting Facility Modifier None Typical Low $16.98 Median $16.98 Typical High $39.81 | Facility | None | $16.98 | $16.98 | $39.81 |
United Setting Professional Modifier None Typical Low $30.90 Median $46.77 Typical High $117.49 | Professional | None | $30.90 | $46.77 | $117.49 |
5 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 $21.88 Median $22.91 Typical High $29.51 | Professional | 52 · Reduced service | $21.88 | $22.91 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $9.12 Typical High $11.75 | Professional | 53 · Discontinued | $8.71 | $9.12 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.92 Typical High $8.71 | Professional | 55 · Aftercare only | $6.61 | $6.92 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.57 Typical High $5.89 | Professional | 56 · Pre-op care only | $4.37 | $4.57 | $5.89 |
Ambetter Setting Professional Modifier GZ · Expected denial Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | GZ · Expected denial | $28.18 | $28.18 | $28.18 |
Where Georgia sits
The same service costs 3.3 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· 15th of 51
$77.62
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.