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 $173.78 Median $173.78 Typical High $275.42 | Facility | None | $173.78 | $173.78 | $275.42 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $186.21 Typical High $275.42 | Professional | None | $173.78 | $186.21 | $275.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $426.58 Median $1,479.11 Typical High $1,548.82 | Facility | None | $426.58 | $1,479.11 | $1,548.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $234.42 Median $346.74 Typical High $1,202.26 | Professional | None | $234.42 | $346.74 | $1,202.26 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $25.12 Median $56.23 Typical High $257.04 | Professional | RR · Rental | $25.12 | $56.23 | $257.04 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $186.21 Median $426.58 Typical High $1,905.46 | Professional | UE · Used equipment | $186.21 | $426.58 | $1,905.46 |
CareSource Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Facility | None | $354.81 | $354.81 | $354.81 |
CareSource Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $562.34 | Professional | None | $199.53 | $199.53 | $562.34 |
Kaiser Permanente Setting Professional Modifier None Typical Low $295.12 Median $426.58 Typical High $776.25 | Professional | None | $295.12 | $426.58 | $776.25 |
United Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $275.42 | Facility | None | $218.78 | $218.78 | $275.42 |
United Setting Professional Modifier None Typical Low $162.18 Median $208.93 Typical High $537.03 | Professional | None | $162.18 | $208.93 | $537.03 |
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 $87.10 Median $93.33 Typical High $138.04 | Professional | 52 · Reduced service | $87.10 | $93.33 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $37.15 Typical High $54.95 | Professional | 53 · Discontinued | $34.67 | $37.15 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $28.18 Typical High $41.69 | Professional | 55 · Aftercare only | $25.70 | $28.18 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $18.62 Typical High $27.54 | Professional | 56 · Pre-op care only | $17.38 | $18.62 | $27.54 |
Where Georgia sits
The same service costs 2.9 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· 19th of 51
$309
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.