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 $21.88 Median $21.88 Typical High $31.62 | Facility | None | $21.88 | $21.88 | $31.62 |
Aetna Setting Professional Modifier None Typical Low $21.88 Median $22.39 Typical High $33.11 | Professional | None | $21.88 | $22.39 | $33.11 |
Ambetter Setting Professional Modifier None Typical Low $20.89 Median $27.54 Typical High $81.28 | Professional | None | $20.89 | $27.54 | $81.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $53.70 Median $186.21 Typical High $199.53 | Facility | None | $53.70 | $186.21 | $199.53 |
Anthem BCBS Setting Professional Modifier None Typical Low $29.51 Median $46.77 Typical High $199.53 | Professional | None | $29.51 | $46.77 | $199.53 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.24 Median $6.03 Typical High $26.92 | Professional | RR · Rental | $3.24 | $6.03 | $26.92 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $24.55 Median $44.67 Typical High $204.17 | Professional | UE · Used equipment | $24.55 | $44.67 | $204.17 |
CareSource Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Facility | None | $44.67 | $44.67 | $44.67 |
CareSource Setting Professional Modifier None Typical Low $44.67 Median $69.18 Typical High $85.11 | Professional | None | $44.67 | $69.18 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Facility | None | $34.67 | $34.67 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $72.44 | Professional | None | $25.70 | $25.70 | $72.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $38.02 Median $53.70 Typical High $75.86 | Professional | None | $38.02 | $53.70 | $75.86 |
Oscar Health Setting Facility Modifier None Typical Low $2,454.71 Median $2,691.53 Typical High $4,073.80 | Facility | None | $2,454.71 | $2,691.53 | $4,073.80 |
United Setting Facility Modifier None Typical Low $16.22 Median $29.51 Typical High $31.62 | Facility | None | $16.22 | $29.51 | $31.62 |
United Setting Professional Modifier None Typical Low $18.20 Median $26.30 Typical High $67.61 | Professional | None | $18.20 | $26.30 | $67.61 |
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 $10.96 Median $11.22 Typical High $16.60 | Professional | 52 · Reduced service | $10.96 | $11.22 | $16.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $4.47 Typical High $6.61 | Professional | 53 · Discontinued | $4.37 | $4.47 | $6.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.31 Median $3.39 Typical High $5.01 | Professional | 55 · Aftercare only | $3.31 | $3.39 | $5.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.24 Typical High $3.31 | Professional | 56 · Pre-op care only | $2.19 | $2.24 | $3.31 |
Where Georgia sits
The same service costs 3.2 times more in Hawaii than in Washington, DC. 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· 10th of 51
$43.65
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.