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 $87.10 Median $87.10 Typical High $141.25 | Facility | None | $87.10 | $87.10 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $95.50 Typical High $138.04 | Professional | None | $87.10 | $95.50 | $138.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $213.80 Median $741.31 Typical High $794.33 | Facility | None | $213.80 | $741.31 | $794.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $173.78 Typical High $602.56 | Professional | None | $117.49 | $173.78 | $602.56 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $12.59 Median $28.84 Typical High $131.83 | Professional | RR · Rental | $12.59 | $28.84 | $131.83 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $95.50 Median $213.80 Typical High $977.24 | Professional | UE · Used equipment | $95.50 | $213.80 | $977.24 |
CareSource Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Facility | None | $177.83 | $177.83 | $177.83 |
CareSource Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $288.40 | Professional | None | $120.23 | $120.23 | $288.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $151.36 Median $213.80 Typical High $398.11 | Professional | None | $151.36 | $213.80 | $398.11 |
United Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $141.25 | Facility | None | $138.04 | $138.04 | $141.25 |
United Setting Professional Modifier None Typical Low $83.18 Median $104.71 Typical High $269.15 | Professional | None | $83.18 | $104.71 | $269.15 |
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 $43.65 Median $46.77 Typical High $69.18 | Professional | 52 · Reduced service | $43.65 | $46.77 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $19.05 Typical High $27.54 | Professional | 53 · Discontinued | $17.78 | $19.05 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $14.13 Typical High $20.89 | Professional | 55 · Aftercare only | $13.18 | $14.13 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $9.55 Typical High $13.80 | Professional | 56 · Pre-op care only | $8.71 | $9.55 | $13.80 |
Where Georgia sits
The same service costs 2.8 times more in Hawaii 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· 18th of 51
$166
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.