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 $95.50 Median $95.50 Typical High $154.88 | Facility | None | $95.50 | $95.50 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $102.33 Typical High $144.54 | Professional | None | $95.50 | $102.33 | $144.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $234.42 Median $812.83 Typical High $870.96 | Facility | None | $234.42 | $812.83 | $870.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $128.82 Median $190.55 Typical High $660.69 | Professional | None | $128.82 | $190.55 | $660.69 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $13.80 Median $28.18 Typical High $128.82 | Professional | RR · Rental | $13.80 | $28.18 | $128.82 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $102.33 Median $213.80 Typical High $977.24 | Professional | UE · Used equipment | $102.33 | $213.80 | $977.24 |
CareSource Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
CareSource Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $316.23 | Professional | None | $128.82 | $128.82 | $316.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $165.96 Median $234.42 Typical High $389.05 | Professional | None | $165.96 | $234.42 | $389.05 |
United Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $109.65 | Facility | None | $85.11 | $85.11 | $109.65 |
United Setting Professional Modifier None Typical Low $81.28 Median $114.82 Typical High $295.12 | Professional | None | $81.28 | $114.82 | $295.12 |
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 $47.86 Median $51.29 Typical High $72.44 | Professional | 52 · Reduced service | $47.86 | $51.29 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $20.42 Typical High $28.84 | Professional | 53 · Discontinued | $19.05 | $20.42 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $15.49 Typical High $21.88 | Professional | 55 · Aftercare only | $14.45 | $15.49 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $10.23 Typical High $14.45 | Professional | 56 · Pre-op care only | $9.55 | $10.23 | $14.45 |
Where Georgia sits
The same service costs 2.0 times more in Wisconsin 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· 18th of 51
$174
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.