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 $123.03 Median $123.03 Typical High $194.98 | Facility | None | $123.03 | $123.03 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $128.82 Typical High $186.21 | Professional | None | $123.03 | $128.82 | $186.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $302.00 Median $1,047.13 Typical High $1,096.48 | Facility | None | $302.00 | $1,047.13 | $1,096.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $165.96 Median $263.03 Typical High $977.24 | Professional | None | $165.96 | $263.03 | $977.24 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $17.78 Median $36.31 Typical High $165.96 | Professional | RR · Rental | $17.78 | $36.31 | $165.96 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $131.83 Median $269.15 Typical High $1,230.27 | Professional | UE · Used equipment | $131.83 | $269.15 | $1,230.27 |
CareSource Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
CareSource Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $398.11 | Professional | None | $120.23 | $120.23 | $398.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $208.93 Median $302.00 Typical High $426.58 | Professional | None | $208.93 | $302.00 | $426.58 |
United Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $141.25 | Facility | None | $134.90 | $134.90 | $141.25 |
United Setting Professional Modifier None Typical Low $104.71 Median $147.91 Typical High $380.19 | Professional | None | $104.71 | $147.91 | $380.19 |
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 $61.66 Median $63.10 Typical High $93.33 | Professional | 52 · Reduced service | $61.66 | $63.10 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $25.70 Typical High $37.15 | Professional | 53 · Discontinued | $24.55 | $25.70 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $19.05 Typical High $28.18 | Professional | 55 · Aftercare only | $18.20 | $19.05 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.88 Typical High $18.62 | Professional | 56 · Pre-op care only | $12.30 | $12.88 | $18.62 |
Where Georgia sits
The same service costs 2.8 times more in Montana 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· 13th of 51
$245
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.