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 $9.55 Median $9.55 Typical High $15.14 | Facility | None | $9.55 | $9.55 | $15.14 |
Aetna Setting Professional Modifier None Typical Low $9.55 Median $9.77 Typical High $14.45 | Professional | None | $9.55 | $9.77 | $14.45 |
Ambetter Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $44.67 | Professional | None | $11.75 | $11.75 | $44.67 |
Anthem BCBS Setting Facility Modifier None Typical Low $23.44 Median $79.43 Typical High $85.11 | Facility | None | $23.44 | $79.43 | $85.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.59 Median $19.95 Typical High $117.49 | Professional | None | $12.59 | $19.95 | $117.49 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.35 Median $2.57 Typical High $11.75 | Professional | RR · Rental | $1.35 | $2.57 | $11.75 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $10.23 Median $19.05 Typical High $87.10 | Professional | UE · Used equipment | $10.23 | $19.05 | $87.10 |
CareSource Setting Facility Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Facility | None | $19.50 | $19.50 | $19.50 |
CareSource Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
Cigna Setting Facility Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Facility | None | $14.45 | $14.45 | $14.45 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $30.90 | Professional | None | $10.47 | $10.47 | $30.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $16.22 Median $23.44 Typical High $32.36 | Professional | None | $16.22 | $23.44 | $32.36 |
United Setting Facility Modifier None Typical Low $12.59 Median $12.59 Typical High $12.88 | Facility | None | $12.59 | $12.59 | $12.88 |
United Setting Professional Modifier None Typical Low $7.59 Median $11.22 Typical High $28.84 | Professional | None | $7.59 | $11.22 | $28.84 |
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 $4.79 Median $4.90 Typical High $7.24 | Professional | 52 · Reduced service | $4.79 | $4.90 | $7.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.91 Median $1.95 Typical High $2.88 | Professional | 53 · Discontinued | $1.91 | $1.95 | $2.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.41 Median $1.45 Typical High $2.14 | Professional | 55 · Aftercare only | $1.41 | $1.45 | $2.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.95 Median $0.98 Typical High $1.45 | Professional | 56 · Pre-op care only | $0.95 | $0.98 | $1.45 |
Where Georgia sits
The same service costs 3.0 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· 11th of 51
$18.62
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.