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 $37.15 Median $37.15 Typical High $58.88 | Facility | None | $37.15 | $37.15 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $38.90 Typical High $56.23 | Professional | None | $37.15 | $38.90 | $56.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $89.13 Median $309.03 Typical High $331.13 | Facility | None | $89.13 | $309.03 | $331.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $48.98 Median $77.62 Typical High $489.78 | Professional | None | $48.98 | $77.62 | $489.78 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.79 Median $10.72 Typical High $48.98 | Professional | RR · Rental | $4.79 | $10.72 | $48.98 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $35.48 Median $79.43 Typical High $363.08 | Professional | UE · Used equipment | $35.48 | $79.43 | $363.08 |
CareSource Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
CareSource Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $120.23 | Professional | None | $58.88 | $58.88 | $120.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $63.10 Median $89.13 Typical High $147.91 | Professional | None | $63.10 | $89.13 | $147.91 |
United Setting Professional Modifier None Typical Low $30.90 Median $43.65 Typical High $112.20 | Professional | None | $30.90 | $43.65 | $112.20 |
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 $18.20 Median $19.50 Typical High $28.18 | Professional | 52 · Reduced service | $18.20 | $19.50 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $7.76 Typical High $11.22 | Professional | 53 · Discontinued | $7.41 | $7.76 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $5.75 Typical High $8.32 | Professional | 55 · Aftercare only | $5.50 | $5.75 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $3.89 Typical High $5.62 | Professional | 56 · Pre-op care only | $3.72 | $3.89 | $5.62 |
Where Georgia sits
The same service costs 2.0 times more in Montana than in South Carolina. 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· 13th of 51
$74.13
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.