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 $12.59 Median $12.59 Typical High $19.95 | Facility | None | $12.59 | $12.59 | $19.95 |
Aetna Setting Professional Modifier None Typical Low $12.59 Median $13.49 Typical High $33.11 | Professional | None | $12.59 | $13.49 | $33.11 |
Ambetter Setting Professional Modifier None Typical Low $15.49 Median $22.91 Typical High $58.88 | Professional | None | $15.49 | $22.91 | $58.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $30.90 Median $107.15 Typical High $112.20 | Facility | None | $30.90 | $107.15 | $112.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.22 Median $26.92 Typical High $144.54 | Professional | None | $16.22 | $26.92 | $144.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.82 Median $3.16 Typical High $14.45 | Professional | RR · Rental | $1.82 | $3.16 | $14.45 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $13.49 Median $23.99 Typical High $109.65 | Professional | UE · Used equipment | $13.49 | $23.99 | $109.65 |
CareSource Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Facility | None | $25.70 | $25.70 | $25.70 |
CareSource Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Cigna Setting Facility Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Facility | None | $16.22 | $16.22 | $16.22 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $40.74 | Professional | None | $12.02 | $12.02 | $40.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $21.38 Median $30.90 Typical High $43.65 | Professional | None | $21.38 | $30.90 | $43.65 |
Oscar Health Setting Facility Modifier None Typical Low $9,549.93 Median $9,549.93 Typical High $14,454.40 | Facility | None | $9,549.93 | $9,549.93 | $14,454.40 |
United Setting Facility Modifier None Typical Low $12.88 Median $12.88 Typical High $15.49 | Facility | None | $12.88 | $12.88 | $15.49 |
United Setting Professional Modifier None Typical Low $10.00 Median $15.14 Typical High $38.90 | Professional | None | $10.00 | $15.14 | $38.90 |
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 $6.31 Median $6.46 Typical High $9.55 | Professional | 52 · Reduced service | $6.31 | $6.46 | $9.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.51 Median $2.57 Typical High $3.80 | Professional | 53 · Discontinued | $2.51 | $2.57 | $3.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.86 Median $1.91 Typical High $2.88 | Professional | 55 · Aftercare only | $1.86 | $1.91 | $2.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.26 Median $1.29 Typical High $1.91 | Professional | 56 · Pre-op care only | $1.26 | $1.29 | $1.91 |
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· 5th of 51
$25.12
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.