How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $194.98 Typical High $194.98 | Professional | None | $125.89 | $194.98 | $194.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $57.54 Typical High $58.88 | Professional | None | $50.12 | $57.54 | $58.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.57 Median $5.75 Typical High $5.75 | Professional | RR · Rental | $4.57 | $5.75 | $5.75 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $34.67 Median $42.66 Typical High $42.66 | Professional | UE · Used equipment | $34.67 | $42.66 | $42.66 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $95.50 Median $316.23 Typical High $316.23 | Professional | None | $95.50 | $316.23 | $316.23 |
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 $91.20 Median $91.20 Typical High $91.20 | Professional | 52 · Reduced service | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | 53 · Discontinued | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $18.20 |
Where Georgia sits
The same service costs 26.3 times more in Rhode Island than in South Carolina. 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· 42nd of 51
$58.88
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.