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 $165.96 Median $165.96 Typical High $269.15 | Facility | None | $165.96 | $165.96 | $269.15 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $173.78 Typical High $251.19 | Professional | None | $165.96 | $173.78 | $251.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $407.38 Median $1,412.54 Typical High $1,513.56 | Facility | None | $407.38 | $1,412.54 | $1,513.56 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $354.81 Typical High $1,318.26 | Professional | None | $204.17 | $354.81 | $1,318.26 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $20.42 Median $45.71 Typical High $208.93 | Professional | RR · Rental | $20.42 | $45.71 | $208.93 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $154.88 Median $346.74 Typical High $1,548.82 | Professional | UE · Used equipment | $154.88 | $346.74 | $1,548.82 |
CareSource Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
CareSource Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
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 $549.54 | Professional | None | $177.83 | $177.83 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $288.40 Median $407.38 Typical High $645.65 | Professional | None | $288.40 | $407.38 | $645.65 |
United Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $173.78 | Facility | None | $169.82 | $169.82 | $173.78 |
United Setting Professional Modifier None Typical Low $131.83 Median $199.53 Typical High $512.86 | Professional | None | $131.83 | $199.53 | $512.86 |
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 $83.18 Median $87.10 Typical High $125.89 | Professional | 52 · Reduced service | $83.18 | $87.10 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $34.67 Typical High $51.29 | Professional | 53 · Discontinued | $33.11 | $34.67 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $26.30 Typical High $38.02 | Professional | 55 · Aftercare only | $25.12 | $26.30 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $17.38 Typical High $25.12 | Professional | 56 · Pre-op care only | $16.60 | $17.38 | $25.12 |
Where Georgia sits
The same service costs 2.3 times more in Wisconsin than in Colorado. 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· 12th of 51
$331
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.