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 $144.54 Median $144.54 Typical High $234.42 | Facility | None | $144.54 | $144.54 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $158.49 Typical High $223.87 | Professional | None | $144.54 | $158.49 | $223.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $354.81 Median $1,230.27 Typical High $1,318.26 | Facility | None | $354.81 | $1,230.27 | $1,318.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $194.98 Median $309.03 Typical High $1,348.96 | Professional | None | $194.98 | $309.03 | $1,348.96 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $21.88 Median $47.86 Typical High $218.78 | Professional | RR · Rental | $21.88 | $47.86 | $218.78 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $162.18 Median $354.81 Typical High $1,621.81 | Professional | UE · Used equipment | $162.18 | $354.81 | $1,621.81 |
CareSource Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
CareSource Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $478.63 | Professional | None | $177.83 | $177.83 | $478.63 |
Kaiser Permanente Setting Professional Modifier None Typical Low $251.19 Median $354.81 Typical High $501.19 | Professional | None | $251.19 | $354.81 | $501.19 |
United Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $281.84 | Facility | None | $234.42 | $234.42 | $281.84 |
United Setting Professional Modifier None Typical Low $138.04 Median $173.78 Typical High $446.68 | Professional | None | $138.04 | $173.78 | $446.68 |
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 $72.44 Median $77.62 Typical High $109.65 | Professional | 52 · Reduced service | $72.44 | $77.62 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $31.62 Typical High $44.67 | Professional | 53 · Discontinued | $29.51 | $31.62 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $23.44 Typical High $33.11 | Professional | 55 · Aftercare only | $21.88 | $23.44 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $15.85 Typical High $22.39 | Professional | 56 · Pre-op care only | $14.45 | $15.85 | $22.39 |
Where Georgia sits
The same service costs 3.6 times more in Hawaii than in Tennessee. 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· 18th of 51
$288
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.