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 $44.67 Median $44.67 Typical High $61.66 | Facility | None | $44.67 | $44.67 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $45.71 Typical High $58.88 | Professional | None | $44.67 | $45.71 | $58.88 |
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 $354.81 | Professional | None | $51.29 | $83.18 | $354.81 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.90 Median $11.22 Typical High $51.29 | Professional | RR · Rental | $4.90 | $11.22 | $51.29 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $37.15 Median $85.11 Typical High $389.05 | Professional | UE · Used equipment | $37.15 | $85.11 | $389.05 |
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 $56.23 Median $56.23 Typical High $64.57 | Facility | None | $56.23 | $56.23 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $128.82 | Professional | None | $41.69 | $41.69 | $128.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $66.07 Median $95.50 Typical High $134.90 | Professional | None | $66.07 | $95.50 | $134.90 |
United Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Facility | None | $44.67 | $44.67 | $44.67 |
United Setting Professional Modifier None Typical Low $30.90 Median $46.77 Typical High $120.23 | Professional | None | $30.90 | $46.77 | $120.23 |
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 $22.39 Median $22.39 Typical High $29.51 | Professional | 52 · Reduced service | $22.39 | $22.39 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $9.12 Typical High $11.75 | Professional | 53 · Discontinued | $8.91 | $9.12 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.76 Typical High $8.91 | Professional | 55 · Aftercare only | $6.61 | $6.76 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $4.47 Typical High $5.89 | Professional | 56 · Pre-op care only | $4.47 | $4.47 | $5.89 |
Where Georgia sits
The same service costs 2.6 times more in Kansas than in Arizona. 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
$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.