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 $199.53 Median $199.53 Typical High $281.84 | Facility | None | $199.53 | $199.53 | $281.84 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $251.19 Typical High $524.81 | Professional | None | $199.53 | $251.19 | $524.81 |
Ambetter Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $426.58 Median $1,479.11 Typical High $1,584.89 | Facility | None | $426.58 | $1,479.11 | $1,584.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $234.42 Median $371.54 Typical High $1,380.38 | Professional | None | $234.42 | $371.54 | $1,380.38 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $24.55 Median $56.23 Typical High $257.04 | Professional | RR · Rental | $24.55 | $56.23 | $257.04 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $186.21 Median $416.87 Typical High $1,905.46 | Professional | UE · Used equipment | $186.21 | $416.87 | $1,905.46 |
CareSource Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Facility | None | $354.81 | $354.81 | $354.81 |
CareSource Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $575.44 | Professional | None | $194.98 | $194.98 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $302.00 Median $426.58 Typical High $602.56 | Professional | None | $302.00 | $426.58 | $602.56 |
Oscar Health Setting Professional Modifier None Typical Low $436.52 Median $616.60 Typical High $933.25 | Professional | None | $436.52 | $616.60 | $933.25 |
United Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $275.42 | Facility | None | $213.80 | $213.80 | $275.42 |
United Setting Professional Modifier None Typical Low $141.25 Median $208.93 Typical High $537.03 | Professional | None | $141.25 | $208.93 | $537.03 |
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 $100.00 Median $102.33 Typical High $131.83 | Professional | 52 · Reduced service | $100.00 | $102.33 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $41.69 Typical High $53.70 | Professional | 53 · Discontinued | $39.81 | $41.69 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.90 Typical High $39.81 | Professional | 55 · Aftercare only | $30.20 | $30.90 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $20.89 Typical High $26.92 | Professional | 56 · Pre-op care only | $19.95 | $20.89 | $26.92 |
Where Georgia sits
The same service costs 4.7 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
$347
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.