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 $218.78 Median $218.78 Typical High $354.81 | Facility | None | $218.78 | $218.78 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $234.42 Typical High $331.13 | Professional | None | $218.78 | $234.42 | $331.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $288.40 Median $467.74 Typical High $1,548.82 | Professional | None | $288.40 | $467.74 | $1,548.82 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $38.90 Median $64.57 Typical High $295.12 | Professional | RR · Rental | $38.90 | $64.57 | $295.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $288.40 Median $478.63 Typical High $2,187.76 | Professional | UE · Used equipment | $288.40 | $478.63 | $2,187.76 |
CareSource Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
CareSource Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $724.44 | Professional | None | $354.81 | $354.81 | $724.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $380.19 Median $537.03 Typical High $891.25 | Professional | None | $380.19 | $537.03 | $891.25 |
United Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
United Setting Professional Modifier None Typical Low $186.21 Median $263.03 Typical High $676.08 | Professional | None | $186.21 | $263.03 | $676.08 |
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 $109.65 Median $117.49 Typical High $165.96 | Professional | 52 · Reduced service | $109.65 | $117.49 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $46.77 Typical High $66.07 | Professional | 53 · Discontinued | $43.65 | $46.77 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $35.48 Typical High $50.12 | Professional | 55 · Aftercare only | $33.11 | $35.48 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $23.44 Typical High $33.11 | Professional | 56 · Pre-op care only | $21.88 | $23.44 | $33.11 |
Where Georgia sits
The same service costs 2.5 times more in Montana than in New York. 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· 12th of 51
$437
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.