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 $64.57 Median $64.57 Typical High $102.33 | Facility | None | $64.57 | $64.57 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $69.18 Typical High $97.72 | Professional | None | $64.57 | $69.18 | $97.72 |
Ambetter Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $154.88 Median $537.03 Typical High $575.44 | Facility | None | $154.88 | $537.03 | $575.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $85.11 Median $128.82 Typical High $446.68 | Professional | None | $85.11 | $128.82 | $446.68 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $9.33 Median $20.89 Typical High $95.50 | Professional | RR · Rental | $9.33 | $20.89 | $95.50 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $69.18 Median $154.88 Typical High $707.95 | Professional | UE · Used equipment | $69.18 | $154.88 | $707.95 |
CareSource Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
CareSource Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
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 $208.93 | Professional | None | $72.44 | $72.44 | $208.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $109.65 Median $154.88 Typical High $223.87 | Professional | None | $109.65 | $154.88 | $223.87 |
United Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $75.86 | Facility | None | $60.26 | $60.26 | $75.86 |
United Setting Professional Modifier None Typical Low $60.26 Median $75.86 Typical High $194.98 | Professional | None | $60.26 | $75.86 | $194.98 |
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 $31.62 Median $34.67 Typical High $48.98 | Professional | 52 · Reduced service | $31.62 | $34.67 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $13.80 Typical High $19.50 | Professional | 53 · Discontinued | $12.88 | $13.80 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $10.23 Typical High $14.45 | Professional | 55 · Aftercare only | $9.55 | $10.23 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.92 Typical High $9.77 | Professional | 56 · Pre-op care only | $6.46 | $6.92 | $9.77 |
Where Georgia sits
The same service costs 2.9 times more in Montana 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· 22nd of 51
$115
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.