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 $13.80 Median $13.80 Typical High $21.88 | Facility | None | $13.80 | $13.80 | $21.88 |
Aetna Setting Professional Modifier None Typical Low $13.80 Median $14.13 Typical High $20.89 | Professional | None | $13.80 | $14.13 | $20.89 |
Ambetter Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $33.88 Median $117.49 Typical High $123.03 | Facility | None | $33.88 | $117.49 | $123.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $18.62 Median $29.51 Typical High $125.89 | Professional | None | $18.62 | $29.51 | $125.89 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.00 Median $3.63 Typical High $16.60 | Professional | RR · Rental | $2.00 | $3.63 | $16.60 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $14.79 Median $26.92 Typical High $123.03 | Professional | UE · Used equipment | $14.79 | $26.92 | $123.03 |
CareSource Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Facility | None | $28.18 | $28.18 | $28.18 |
CareSource Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
Cigna Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
Cigna Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $45.71 | Professional | None | $13.49 | $13.49 | $45.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $23.44 Median $33.88 Typical High $47.86 | Professional | None | $23.44 | $33.88 | $47.86 |
United Setting Facility Modifier None Typical Low $14.45 Median $14.45 Typical High $16.60 | Facility | None | $14.45 | $14.45 | $16.60 |
United Setting Professional Modifier None Typical Low $10.96 Median $16.60 Typical High $42.66 | Professional | None | $10.96 | $16.60 | $42.66 |
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 $6.92 Median $7.08 Typical High $10.47 | Professional | 52 · Reduced service | $6.92 | $7.08 | $10.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.75 Median $2.82 Typical High $4.17 | Professional | 53 · Discontinued | $2.75 | $2.82 | $4.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.04 Median $2.09 Typical High $3.16 | Professional | 55 · Aftercare only | $2.04 | $2.09 | $3.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.38 Median $1.41 Typical High $2.09 | Professional | 56 · Pre-op care only | $1.38 | $1.41 | $2.09 |
Where Georgia sits
The same service costs 2.8 times more in Hawaii than in Pennsylvania. 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
$27.54
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.