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 $95.50 Median $95.50 Typical High $134.90 | Facility | None | $95.50 | $95.50 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $125.89 Typical High $251.19 | Professional | None | $95.50 | $125.89 | $251.19 |
Ambetter Setting Professional Modifier None Typical Low $158.49 Median $302.00 Typical High $398.11 | Professional | None | $158.49 | $302.00 | $398.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $208.93 Median $724.44 Typical High $758.58 | Facility | None | $208.93 | $724.44 | $758.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $120.23 Median $181.97 Typical High $588.84 | Professional | None | $120.23 | $181.97 | $588.84 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.48 Median $20.89 Typical High $112.20 | Professional | RR · Rental | $11.48 | $20.89 | $112.20 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $87.10 Median $154.88 Typical High $831.76 | Professional | UE · Used equipment | $87.10 | $154.88 | $831.76 |
CareSource Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
CareSource Setting Professional Modifier None Typical Low $173.78 Median $263.03 Typical High $323.59 | Professional | None | $173.78 | $263.03 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $125.89 Typical High $125.89 | Facility | None | $107.15 | $125.89 | $125.89 |
Cigna Setting Facility Modifier RR · Rental Typical Low $12.59 Median $12.59 Typical High $12.59 | Facility | RR · Rental | $12.59 | $12.59 | $12.59 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $275.42 | Professional | None | $93.33 | $93.33 | $275.42 |
Cigna Setting Professional Modifier RR · Rental Typical Low $10.72 Median $10.72 Typical High $12.59 | Professional | RR · Rental | $10.72 | $10.72 | $12.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $144.54 Median $208.93 Typical High $407.38 | Professional | None | $144.54 | $208.93 | $407.38 |
United Setting Professional Modifier None Typical Low $67.61 Median $102.33 Typical High $263.03 | Professional | None | $67.61 | $102.33 | $263.03 |
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 $47.86 Median $48.98 Typical High $64.57 | Professional | 52 · Reduced service | $47.86 | $48.98 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $19.50 Typical High $25.70 | Professional | 53 · Discontinued | $19.50 | $19.50 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $14.79 Typical High $19.50 | Professional | 55 · Aftercare only | $14.45 | $14.79 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $9.77 Typical High $12.88 | Professional | 56 · Pre-op care only | $9.55 | $9.77 | $12.88 |
Where Georgia sits
The same service costs 2.1 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· 12th of 51
$170
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.