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 $275.42 Median $275.42 Typical High $436.52 | Facility | None | $275.42 | $275.42 | $436.52 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $295.12 Typical High $426.58 | Professional | None | $275.42 | $295.12 | $426.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $2,290.87 Typical High $2,454.71 | Facility | None | $660.69 | $2,290.87 | $2,454.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $363.08 Median $575.44 Typical High $2,137.96 | Professional | None | $363.08 | $575.44 | $2,137.96 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $39.81 Median $89.13 Typical High $407.38 | Professional | RR · Rental | $39.81 | $89.13 | $407.38 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $295.12 Median $660.69 Typical High $3,019.95 | Professional | UE · Used equipment | $295.12 | $660.69 | $3,019.95 |
CareSource Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Facility | None | $562.34 | $562.34 | $562.34 |
CareSource Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $891.25 | Professional | None | $354.81 | $354.81 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $467.74 Median $660.69 Typical High $954.99 | Professional | None | $467.74 | $660.69 | $954.99 |
Oscar Health Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $891.25 | Professional | None | $776.25 | $776.25 | $891.25 |
United Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $323.59 | Facility | None | $165.96 | $165.96 | $323.59 |
United Setting Professional Modifier None Typical Low $257.04 Median $323.59 Typical High $831.76 | Professional | None | $257.04 | $323.59 | $831.76 |
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 $134.90 Median $147.91 Typical High $213.80 | Professional | 52 · Reduced service | $134.90 | $147.91 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $58.88 Typical High $85.11 | Professional | 53 · Discontinued | $54.95 | $58.88 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $43.65 Typical High $64.57 | Professional | 55 · Aftercare only | $40.74 | $43.65 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $29.51 Typical High $42.66 | Professional | 56 · Pre-op care only | $27.54 | $29.51 | $42.66 |
Where Georgia sits
The same service costs 2.4 times more in Iowa than in Kansas. 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· 14th of 51
$550
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.