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 $38.02 Median $38.02 Typical High $60.26 | Facility | None | $38.02 | $38.02 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $39.81 Typical High $57.54 | Professional | None | $38.02 | $39.81 | $57.54 |
Ambetter Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $93.33 Median $323.59 Typical High $338.84 | Facility | None | $93.33 | $323.59 | $338.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $51.29 Median $75.86 Typical High $263.03 | Professional | None | $51.29 | $75.86 | $263.03 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.50 Median $10.96 Typical High $50.12 | Professional | RR · Rental | $5.50 | $10.96 | $50.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $40.74 Median $83.18 Typical High $380.19 | Professional | UE · Used equipment | $40.74 | $83.18 | $380.19 |
CareSource Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
CareSource Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $125.89 | Professional | None | $37.15 | $37.15 | $125.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $64.57 Median $93.33 Typical High $131.83 | Professional | None | $64.57 | $93.33 | $131.83 |
United Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Facility | None | $44.67 | $44.67 | $44.67 |
United Setting Professional Modifier None Typical Low $31.62 Median $45.71 Typical High $117.49 | Professional | None | $31.62 | $45.71 | $117.49 |
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 $19.05 Median $19.95 Typical High $28.84 | Professional | 52 · Reduced service | $19.05 | $19.95 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.94 Typical High $11.48 | Professional | 53 · Discontinued | $7.59 | $7.94 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $6.03 Typical High $8.71 | Professional | 55 · Aftercare only | $5.75 | $6.03 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.98 Typical High $5.75 | Professional | 56 · Pre-op care only | $3.80 | $3.98 | $5.75 |
Where Georgia sits
The same service costs 2.8 times more in Kansas 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· 18th of 51
$66.07
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.