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 $95.50 Median $95.50 Typical High $154.88 | Facility | None | $95.50 | $95.50 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $104.71 Typical High $147.91 | Professional | None | $95.50 | $104.71 | $147.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $234.42 Median $812.83 Typical High $870.96 | Facility | None | $234.42 | $812.83 | $870.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $128.82 Median $204.17 Typical High $758.58 | Professional | None | $128.82 | $204.17 | $758.58 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $13.80 Median $30.20 Typical High $138.04 | Professional | RR · Rental | $13.80 | $30.20 | $138.04 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $102.33 Median $229.09 Typical High $1,047.13 | Professional | UE · Used equipment | $102.33 | $229.09 | $1,047.13 |
CareSource Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
CareSource Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $316.23 | Professional | None | $117.49 | $117.49 | $316.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $165.96 Median $234.42 Typical High $416.87 | Professional | None | $165.96 | $234.42 | $416.87 |
United Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $131.83 | Facility | None | $107.15 | $107.15 | $131.83 |
United Setting Professional Modifier None Typical Low $87.10 Median $114.82 Typical High $295.12 | Professional | None | $87.10 | $114.82 | $295.12 |
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 $47.86 Median $51.29 Typical High $72.44 | Professional | 52 · Reduced service | $47.86 | $51.29 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $20.89 Typical High $29.51 | Professional | 53 · Discontinued | $19.50 | $20.89 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $15.49 Typical High $21.88 | Professional | 55 · Aftercare only | $14.45 | $15.49 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $10.23 Typical High $14.79 | Professional | 56 · Pre-op care only | $9.55 | $10.23 | $14.79 |
Where Georgia sits
The same service costs 2.4 times more in Hawaii 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· 14th of 51
$191
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.