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 $93.33 Median $93.33 Typical High $147.91 | Facility | None | $93.33 | $93.33 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $100.00 Typical High $141.25 | Professional | None | $93.33 | $100.00 | $141.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $229.09 Median $776.25 Typical High $831.76 | Facility | None | $229.09 | $776.25 | $831.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $123.03 Median $194.98 Typical High $741.31 | Professional | None | $123.03 | $194.98 | $741.31 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $13.49 Median $30.20 Typical High $138.04 | Professional | RR · Rental | $13.49 | $30.20 | $138.04 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $100.00 Median $229.09 Typical High $1,023.29 | Professional | UE · Used equipment | $100.00 | $229.09 | $1,023.29 |
CareSource Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
CareSource Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $302.00 | Professional | None | $102.33 | $102.33 | $302.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $158.49 Median $229.09 Typical High $323.59 | Professional | None | $158.49 | $229.09 | $323.59 |
United Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $154.88 | Facility | None | $147.91 | $147.91 | $154.88 |
United Setting Professional Modifier None Typical Low $87.10 Median $109.65 Typical High $281.84 | Professional | None | $87.10 | $109.65 | $281.84 |
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 $46.77 Median $50.12 Typical High $70.79 | Professional | 52 · Reduced service | $46.77 | $50.12 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $19.95 Typical High $28.18 | Professional | 53 · Discontinued | $18.62 | $19.95 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $14.79 Typical High $20.89 | Professional | 55 · Aftercare only | $13.80 | $14.79 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $10.00 Typical High $14.13 | Professional | 56 · Pre-op care only | $9.33 | $10.00 | $14.13 |
Where Georgia sits
The same service costs 3.5 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
$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.