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 $162.18 Median $162.18 Typical High $229.09 | Facility | None | $162.18 | $162.18 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $204.17 Typical High $426.58 | Professional | None | $162.18 | $204.17 | $426.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $346.74 Median $1,202.26 Typical High $1,288.25 | Facility | None | $346.74 | $1,202.26 | $1,288.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $190.55 Median $302.00 Typical High $1,288.25 | Professional | None | $190.55 | $302.00 | $1,288.25 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $20.42 Median $46.77 Typical High $213.80 | Professional | RR · Rental | $20.42 | $46.77 | $213.80 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $154.88 Median $346.74 Typical High $1,584.89 | Professional | UE · Used equipment | $154.88 | $346.74 | $1,584.89 |
CareSource Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Facility | None | $288.40 | $288.40 | $288.40 |
CareSource Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $245.47 | Facility | None | $229.09 | $229.09 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $467.74 | Professional | None | $165.96 | $165.96 | $467.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $245.47 Median $346.74 Typical High $489.78 | Professional | None | $245.47 | $346.74 | $489.78 |
Oscar Health Setting Professional Modifier None Typical Low $436.52 Median $575.44 Typical High $891.25 | Professional | None | $436.52 | $575.44 | $891.25 |
United Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $251.19 | Facility | None | $229.09 | $229.09 | $251.19 |
United Setting Professional Modifier None Typical Low $114.82 Median $169.82 Typical High $436.52 | Professional | None | $114.82 | $169.82 | $436.52 |
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 $81.28 Median $85.11 Typical High $114.82 | Professional | 52 · Reduced service | $81.28 | $85.11 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $33.88 Typical High $45.71 | Professional | 53 · Discontinued | $32.36 | $33.88 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $25.12 Typical High $33.88 | Professional | 55 · Aftercare only | $24.55 | $25.12 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.98 Typical High $22.91 | Professional | 56 · Pre-op care only | $16.22 | $16.98 | $22.91 |
Where Georgia sits
The same service costs 3.5 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· 16th of 51
$282
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.