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 $66.07 Median $66.07 Typical High $107.15 | Facility | None | $66.07 | $66.07 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $70.79 Typical High $100.00 | Professional | None | $66.07 | $70.79 | $100.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $162.18 Median $562.34 Typical High $602.56 | Facility | None | $162.18 | $562.34 | $602.56 |
Anthem BCBS Setting Professional Modifier None Typical Low $89.13 Median $141.25 Typical High $524.81 | Professional | None | $89.13 | $141.25 | $524.81 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $9.55 Median $21.88 Typical High $100.00 | Professional | RR · Rental | $9.55 | $21.88 | $100.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $72.44 Median $162.18 Typical High $741.31 | Professional | UE · Used equipment | $72.44 | $162.18 | $741.31 |
CareSource Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
CareSource Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $218.78 | Professional | None | $72.44 | $72.44 | $218.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $114.82 Median $162.18 Typical High $229.09 | Professional | None | $114.82 | $162.18 | $229.09 |
United Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $107.15 | Facility | None | $102.33 | $102.33 | $107.15 |
United Setting Professional Modifier None Typical Low $61.66 Median $79.43 Typical High $204.17 | Professional | None | $61.66 | $79.43 | $204.17 |
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 $33.11 Median $35.48 Typical High $50.12 | Professional | 52 · Reduced service | $33.11 | $35.48 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $14.13 Typical High $20.42 | Professional | 53 · Discontinued | $13.18 | $14.13 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.72 Typical High $15.14 | Professional | 55 · Aftercare only | $10.00 | $10.72 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $7.08 Typical High $10.00 | Professional | 56 · Pre-op care only | $6.61 | $7.08 | $10.00 |
Where Georgia sits
The same service costs 4.1 times more in Hawaii 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· 16th of 51
$132
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.