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 $158.49 Median $158.49 Typical High $257.04 | Facility | None | $158.49 | $158.49 | $257.04 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $199.53 Typical High $416.87 | Professional | None | $158.49 | $199.53 | $416.87 |
Ambetter Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $741.31 | Professional | None | $295.12 | $295.12 | $741.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $1,348.96 Typical High $1,412.54 | Facility | None | $389.05 | $1,348.96 | $1,412.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $213.80 Median $338.84 Typical High $1,445.44 | Professional | None | $213.80 | $338.84 | $1,445.44 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $22.91 Median $51.29 Typical High $234.42 | Professional | RR · Rental | $22.91 | $51.29 | $234.42 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $173.78 Median $389.05 Typical High $1,778.28 | Professional | UE · Used equipment | $173.78 | $389.05 | $1,778.28 |
CareSource Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Facility | None | $323.59 | $323.59 | $323.59 |
CareSource Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $524.81 | Professional | None | $181.97 | $181.97 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $275.42 Median $389.05 Typical High $549.54 | Professional | None | $275.42 | $389.05 | $549.54 |
Oscar Health Setting Facility Modifier None Typical Low $9,549.93 Median $9,549.93 Typical High $14,454.40 | Facility | None | $9,549.93 | $9,549.93 | $14,454.40 |
United Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $245.47 | Facility | None | $190.55 | $190.55 | $245.47 |
United Setting Professional Modifier None Typical Low $147.91 Median $190.55 Typical High $489.78 | Professional | None | $147.91 | $190.55 | $489.78 |
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 $79.43 Median $85.11 Typical High $120.23 | Professional | 52 · Reduced service | $79.43 | $85.11 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $33.88 Typical High $47.86 | Professional | 53 · Discontinued | $31.62 | $33.88 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $25.70 Typical High $36.31 | Professional | 55 · Aftercare only | $23.99 | $25.70 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $16.98 Typical High $23.99 | Professional | 56 · Pre-op care only | $15.85 | $16.98 | $23.99 |
Where Georgia sits
The same service costs 2.5 times more in Kansas than in Florida. 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
$316
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.