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 $151.36 Median $151.36 Typical High $239.88 | Facility | None | $151.36 | $151.36 | $239.88 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $162.18 Typical High $229.09 | Professional | None | $151.36 | $162.18 | $229.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $363.08 Median $1,258.93 Typical High $1,348.96 | Facility | None | $363.08 | $1,258.93 | $1,348.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $199.53 Median $316.23 Typical High $1,174.90 | Professional | None | $199.53 | $316.23 | $1,174.90 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $21.38 Median $45.71 Typical High $208.93 | Professional | RR · Rental | $21.38 | $45.71 | $208.93 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $162.18 Median $346.74 Typical High $1,584.89 | Professional | UE · Used equipment | $162.18 | $346.74 | $1,584.89 |
CareSource Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
CareSource Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $489.78 | Professional | None | $199.53 | $199.53 | $489.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $257.04 Median $363.08 Typical High $524.81 | Professional | None | $257.04 | $363.08 | $524.81 |
United Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $173.78 | Facility | None | $158.49 | $158.49 | $173.78 |
United Setting Professional Modifier None Typical Low $131.83 Median $177.83 Typical High $457.09 | Professional | None | $131.83 | $177.83 | $457.09 |
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 $74.13 Median $81.28 Typical High $114.82 | Professional | 52 · Reduced service | $74.13 | $81.28 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $32.36 Typical High $45.71 | Professional | 53 · Discontinued | $30.20 | $32.36 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $23.99 Typical High $33.88 | Professional | 55 · Aftercare only | $22.39 | $23.99 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $16.22 Typical High $22.91 | Professional | 56 · Pre-op care only | $15.14 | $16.22 | $22.91 |
Where Georgia sits
The same service costs 2.0 times more in Wisconsin than in Colorado. 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· 15th of 51
$302
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.