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 $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $144.54 Typical High $302.00 | Professional | None | $114.82 | $144.54 | $302.00 |
Ambetter Setting Professional Modifier None Typical Low $91.20 Median $457.09 Typical High $457.09 | Professional | None | $91.20 | $457.09 | $457.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $144.54 Median $245.47 Typical High $812.83 | Professional | None | $144.54 | $245.47 | $812.83 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $20.42 Median $32.36 Typical High $147.91 | Professional | RR · Rental | $20.42 | $32.36 | $147.91 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $151.36 Median $239.88 Typical High $1,096.48 | Professional | UE · Used equipment | $151.36 | $239.88 | $1,096.48 |
CareSource Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
CareSource Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $380.19 | Professional | None | $165.96 | $165.96 | $380.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $199.53 Median $281.84 Typical High $457.09 | Professional | None | $199.53 | $281.84 | $457.09 |
United Setting Professional Modifier None Typical Low $93.33 Median $138.04 Typical High $354.81 | Professional | None | $93.33 | $138.04 | $354.81 |
2 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 55 · Aftercare only Typical Low $17.38 Median $17.78 Typical High $26.30 | Professional | 55 · Aftercare only | $17.38 | $17.78 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $12.02 Typical High $17.38 | Professional | 56 · Pre-op care only | $11.48 | $12.02 | $17.38 |
Where Georgia sits
The same service costs 2.6 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· 11th of 51
$229
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.