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 $39.81 Median $39.81 Typical High $64.57 | Facility | None | $39.81 | $39.81 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $42.66 Typical High $64.57 | Professional | None | $39.81 | $42.66 | $64.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $97.72 Median $338.84 Typical High $363.08 | Facility | None | $97.72 | $338.84 | $363.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $85.11 Typical High $363.08 | Professional | None | $53.70 | $85.11 | $363.08 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.75 Median $13.18 Typical High $60.26 | Professional | RR · Rental | $5.75 | $13.18 | $60.26 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $43.65 Median $97.72 Typical High $446.68 | Professional | UE · Used equipment | $43.65 | $97.72 | $446.68 |
CareSource Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
CareSource Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $131.83 | Professional | None | $43.65 | $43.65 | $131.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $69.18 Median $97.72 Typical High $138.04 | Professional | None | $69.18 | $97.72 | $138.04 |
United Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $67.61 | Facility | None | $64.57 | $64.57 | $67.61 |
United Setting Professional Modifier None Typical Low $38.02 Median $47.86 Typical High $123.03 | Professional | None | $38.02 | $47.86 | $123.03 |
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 $19.95 Median $21.38 Typical High $32.36 | Professional | 52 · Reduced service | $19.95 | $21.38 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $8.71 Typical High $12.88 | Professional | 53 · Discontinued | $7.94 | $8.71 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.46 Typical High $9.55 | Professional | 55 · Aftercare only | $6.03 | $6.46 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $4.27 Typical High $6.46 | Professional | 56 · Pre-op care only | $3.98 | $4.27 | $6.46 |
Where Georgia sits
The same service costs 3.6 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· 17th of 51
$79.43
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.