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 $91.20 Median $91.20 Typical High $144.54 | Facility | None | $91.20 | $91.20 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $97.72 Typical High $138.04 | Professional | None | $91.20 | $97.72 | $138.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $223.87 Median $776.25 Typical High $812.83 | Facility | None | $223.87 | $776.25 | $812.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $120.23 Median $194.98 Typical High $831.76 | Professional | None | $120.23 | $194.98 | $831.76 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $13.18 Median $29.51 Typical High $134.90 | Professional | RR · Rental | $13.18 | $29.51 | $134.90 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $100.00 Median $223.87 Typical High $1,023.29 | Professional | UE · Used equipment | $100.00 | $223.87 | $1,023.29 |
CareSource Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
CareSource Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $295.12 | Professional | None | $102.33 | $102.33 | $295.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $223.87 Typical High $316.23 | Professional | None | $154.88 | $223.87 | $316.23 |
United Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $158.49 | Facility | None | $144.54 | $144.54 | $158.49 |
United Setting Professional Modifier None Typical Low $85.11 Median $109.65 Typical High $275.42 | Professional | None | $85.11 | $109.65 | $275.42 |
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 $45.71 Median $48.98 Typical High $69.18 | Professional | 52 · Reduced service | $45.71 | $48.98 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $19.50 Typical High $27.54 | Professional | 53 · Discontinued | $18.20 | $19.50 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $14.45 Typical High $20.89 | Professional | 55 · Aftercare only | $13.49 | $14.45 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.77 Typical High $13.80 | Professional | 56 · Pre-op care only | $9.12 | $9.77 | $13.80 |
Where Georgia sits
The same service costs 3.7 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· 15th of 51
$182
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.