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 $186.21 Median $186.21 Typical High $302.00 | Facility | None | $186.21 | $186.21 | $302.00 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $199.53 Typical High $281.84 | Professional | None | $186.21 | $199.53 | $281.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $457.09 Median $1,584.89 Typical High $1,698.24 | Facility | None | $457.09 | $1,584.89 | $1,698.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $251.19 Median $398.11 Typical High $1,479.11 | Professional | None | $251.19 | $398.11 | $1,479.11 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $26.92 Median $58.88 Typical High $269.15 | Professional | RR · Rental | $26.92 | $58.88 | $269.15 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $199.53 Median $436.52 Typical High $1,995.26 | Professional | UE · Used equipment | $199.53 | $436.52 | $1,995.26 |
CareSource Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
CareSource Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $616.60 | Professional | None | $204.17 | $204.17 | $616.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $323.59 Median $457.09 Typical High $645.65 | Professional | None | $323.59 | $457.09 | $645.65 |
United Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $389.05 | Facility | None | $288.40 | $288.40 | $389.05 |
United Setting Professional Modifier None Typical Low $169.82 Median $223.87 Typical High $575.44 | Professional | None | $169.82 | $223.87 | $575.44 |
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 $93.33 Median $100.00 Typical High $141.25 | Professional | 52 · Reduced service | $93.33 | $100.00 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $39.81 Typical High $56.23 | Professional | 53 · Discontinued | $37.15 | $39.81 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $30.20 Typical High $42.66 | Professional | 55 · Aftercare only | $28.18 | $30.20 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $19.95 Typical High $28.18 | Professional | 56 · Pre-op care only | $18.62 | $19.95 | $28.18 |
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
$372
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.