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 $10.72 Median $10.72 Typical High $17.38 | Facility | None | $10.72 | $10.72 | $17.38 |
Aetna Setting Professional Modifier None Typical Low $10.72 Median $11.48 Typical High $16.22 | Professional | None | $10.72 | $11.48 | $16.22 |
Ambetter Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $26.30 Median $91.20 Typical High $97.72 | Facility | None | $26.30 | $91.20 | $97.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $14.45 Median $22.91 Typical High $97.72 | Professional | None | $14.45 | $22.91 | $97.72 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.55 Median $3.39 Typical High $15.49 | Professional | RR · Rental | $1.55 | $3.39 | $15.49 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $11.48 Median $19.95 Typical High $114.82 | Professional | UE · Used equipment | $11.48 | $19.95 | $114.82 |
CareSource Setting Facility Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Facility | None | $21.88 | $21.88 | $21.88 |
CareSource Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
Cigna Setting Facility Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Facility | None | $16.60 | $16.60 | $16.60 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $35.48 | Professional | None | $12.02 | $12.02 | $35.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $18.62 Median $26.30 Typical High $37.15 | Professional | None | $18.62 | $26.30 | $37.15 |
United Setting Facility Modifier None Typical Low $12.88 Median $12.88 Typical High $16.22 | Facility | None | $12.88 | $12.88 | $16.22 |
United Setting Professional Modifier None Typical Low $9.77 Median $12.88 Typical High $33.11 | Professional | None | $9.77 | $12.88 | $33.11 |
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 $5.37 Median $5.75 Typical High $8.13 | Professional | 52 · Reduced service | $5.37 | $5.75 | $8.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.14 Median $2.29 Typical High $3.31 | Professional | 53 · Discontinued | $2.14 | $2.29 | $3.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.62 Median $1.74 Typical High $2.45 | Professional | 55 · Aftercare only | $1.62 | $1.74 | $2.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.07 Median $1.15 Typical High $1.62 | Professional | 56 · Pre-op care only | $1.07 | $1.15 | $1.62 |
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· 16th of 51
$21.38
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.