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 $165.96 Median $165.96 Typical High $263.03 | Facility | None | $165.96 | $165.96 | $263.03 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $177.83 Typical High $251.19 | Professional | None | $165.96 | $177.83 | $251.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $407.38 Median $1,412.54 Typical High $1,479.11 | Facility | None | $407.38 | $1,412.54 | $1,479.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $331.13 Typical High $1,148.15 | Professional | None | $218.78 | $331.13 | $1,148.15 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $21.88 Median $50.12 Typical High $229.09 | Professional | RR · Rental | $21.88 | $50.12 | $229.09 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $165.96 Median $371.54 Typical High $1,698.24 | Professional | UE · Used equipment | $165.96 | $371.54 | $1,698.24 |
CareSource Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
CareSource Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $549.54 | Professional | None | $165.96 | $165.96 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $281.84 Median $407.38 Typical High $575.44 | Professional | None | $281.84 | $407.38 | $575.44 |
United Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $190.55 | Facility | None | $151.36 | $151.36 | $190.55 |
United Setting Professional Modifier None Typical Low $141.25 Median $199.53 Typical High $512.86 | Professional | None | $141.25 | $199.53 | $512.86 |
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 $83.18 Median $89.13 Typical High $125.89 | Professional | 52 · Reduced service | $83.18 | $89.13 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $35.48 Typical High $50.12 | Professional | 53 · Discontinued | $33.11 | $35.48 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $26.92 Typical High $38.02 | Professional | 55 · Aftercare only | $25.12 | $26.92 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $17.78 Typical High $25.12 | Professional | 56 · Pre-op care only | $16.60 | $17.78 | $25.12 |
Where Georgia sits
The same service costs 2.7 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· 17th of 51
$288
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.