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 $25.70 Median $25.70 Typical High $40.74 | Facility | None | $25.70 | $25.70 | $40.74 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $27.54 Typical High $40.74 | Professional | None | $25.70 | $27.54 | $40.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $63.10 Median $218.78 Typical High $229.09 | Facility | None | $63.10 | $218.78 | $229.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.88 Median $51.29 Typical High $177.83 | Professional | None | $33.88 | $51.29 | $177.83 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.89 Median $8.32 Typical High $38.02 | Professional | RR · Rental | $3.89 | $8.32 | $38.02 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $29.51 Median $63.10 Typical High $288.40 | Professional | UE · Used equipment | $29.51 | $63.10 | $288.40 |
CareSource Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
CareSource Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Cigna Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Facility | None | $44.67 | $44.67 | $44.67 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $83.18 | Professional | None | $33.11 | $33.11 | $83.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $43.65 Median $63.10 Typical High $89.13 | Professional | None | $43.65 | $63.10 | $89.13 |
United Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $37.15 | Facility | None | $36.31 | $36.31 | $37.15 |
United Setting Professional Modifier None Typical Low $23.99 Median $30.90 Typical High $77.62 | Professional | None | $23.99 | $30.90 | $77.62 |
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 $12.88 Median $13.80 Typical High $20.42 | Professional | 52 · Reduced service | $12.88 | $13.80 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $5.50 Typical High $8.13 | Professional | 53 · Discontinued | $5.13 | $5.50 | $8.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $4.07 Typical High $6.17 | Professional | 55 · Aftercare only | $3.80 | $4.07 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $2.75 Typical High $4.07 | Professional | 56 · Pre-op care only | $2.57 | $2.75 | $4.07 |
Where Georgia sits
The same service costs 2.5 times more in Hawaii 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· 20th of 51
$45.71
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.