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 $37.15 Median $37.15 Typical High $60.26 | Facility | None | $37.15 | $37.15 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $38.90 Typical High $57.54 | Professional | None | $37.15 | $38.90 | $57.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $91.20 Median $316.23 Typical High $338.84 | Facility | None | $91.20 | $316.23 | $338.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $74.13 Typical High $257.04 | Professional | None | $50.12 | $74.13 | $257.04 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.37 Median $10.72 Typical High $47.86 | Professional | RR · Rental | $5.37 | $10.72 | $47.86 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $39.81 Median $79.43 Typical High $363.08 | Professional | UE · Used equipment | $39.81 | $79.43 | $363.08 |
CareSource Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
CareSource Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $123.03 | Professional | None | $35.48 | $35.48 | $123.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $64.57 Median $91.20 Typical High $151.36 | Professional | None | $64.57 | $91.20 | $151.36 |
United Setting Facility Modifier None Typical Low $19.95 Median $19.95 Typical High $39.81 | Facility | None | $19.95 | $19.95 | $39.81 |
United Setting Professional Modifier None Typical Low $30.20 Median $44.67 Typical High $114.82 | Professional | None | $30.20 | $44.67 | $114.82 |
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 $18.62 Median $19.05 Typical High $28.18 | Professional | 52 · Reduced service | $18.62 | $19.05 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $7.76 Typical High $11.48 | Professional | 53 · Discontinued | $7.41 | $7.76 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.75 Typical High $8.51 | Professional | 55 · Aftercare only | $5.62 | $5.75 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $3.89 Typical High $5.75 | Professional | 56 · Pre-op care only | $3.72 | $3.89 | $5.75 |
Where Georgia sits
The same service costs 2.8 times more in Montana than in New Jersey. 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· 15th of 51
$66.07
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.