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 $114.82 Median $114.82 Typical High $186.21 | Facility | None | $114.82 | $114.82 | $186.21 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $125.89 Typical High $186.21 | Professional | None | $114.82 | $125.89 | $186.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $281.84 Median $977.24 Typical High $1,047.13 | Facility | None | $281.84 | $977.24 | $1,047.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $154.88 Median $229.09 Typical High $794.33 | Professional | None | $154.88 | $229.09 | $794.33 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $16.98 Median $38.02 Typical High $173.78 | Professional | RR · Rental | $16.98 | $38.02 | $173.78 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $125.89 Median $281.84 Typical High $1,288.25 | Professional | UE · Used equipment | $125.89 | $281.84 | $1,288.25 |
CareSource Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
CareSource Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Facility | None | $177.83 | $177.83 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $380.19 | Professional | None | $128.82 | $128.82 | $380.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $199.53 Median $281.84 Typical High $524.81 | Professional | None | $199.53 | $281.84 | $524.81 |
United Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $208.93 | Facility | None | $186.21 | $186.21 | $208.93 |
United Setting Professional Modifier None Typical Low $109.65 Median $138.04 Typical High $354.81 | Professional | None | $109.65 | $138.04 | $354.81 |
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 $57.54 Median $61.66 Typical High $93.33 | Professional | 52 · Reduced service | $57.54 | $61.66 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $25.12 Typical High $37.15 | Professional | 53 · Discontinued | $23.44 | $25.12 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $18.62 Typical High $27.54 | Professional | 55 · Aftercare only | $17.38 | $18.62 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $12.59 Typical High $18.62 | Professional | 56 · Pre-op care only | $11.48 | $12.59 | $18.62 |
Where Georgia sits
The same service costs 3.5 times more in Hawaii 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· 20th of 51
$209
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.