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 $199.53 Median $199.53 Typical High $323.59 | Facility | None | $199.53 | $199.53 | $323.59 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $213.80 Typical High $323.59 | Professional | None | $199.53 | $213.80 | $323.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $489.78 Median $1,698.24 Typical High $1,819.70 | Facility | None | $489.78 | $1,698.24 | $1,819.70 |
Anthem BCBS Setting Professional Modifier None Typical Low $269.15 Median $426.58 Typical High $3,019.95 | Professional | None | $269.15 | $426.58 | $3,019.95 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $29.51 Median $66.07 Typical High $302.00 | Professional | RR · Rental | $29.51 | $66.07 | $302.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $218.78 Median $489.78 Typical High $2,238.72 | Professional | UE · Used equipment | $218.78 | $489.78 | $2,238.72 |
CareSource Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
CareSource Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $660.69 | Professional | None | $269.15 | $269.15 | $660.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $346.74 Median $489.78 Typical High $912.01 | Professional | None | $346.74 | $489.78 | $912.01 |
Oscar Health Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $645.65 | Professional | None | $562.34 | $562.34 | $645.65 |
United Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $323.59 | Facility | None | $239.88 | $239.88 | $323.59 |
United Setting Professional Modifier None Typical Low $186.21 Median $239.88 Typical High $616.60 | Professional | None | $186.21 | $239.88 | $616.60 |
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 $100.00 Median $107.15 Typical High $162.18 | Professional | 52 · Reduced service | $100.00 | $107.15 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $42.66 Typical High $64.57 | Professional | 53 · Discontinued | $39.81 | $42.66 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $32.36 Typical High $47.86 | Professional | 55 · Aftercare only | $30.20 | $32.36 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $21.38 Typical High $32.36 | Professional | 56 · Pre-op care only | $19.95 | $21.38 | $32.36 |
Where Georgia sits
The same service costs 2.6 times more in Hawaii than in Alabama. 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
$398
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.