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 $13.18 Median $13.18 Typical High $21.38 | Facility | None | $13.18 | $13.18 | $21.38 |
Aetna Setting Professional Modifier None Typical Low $13.18 Median $13.80 Typical High $19.95 | Professional | None | $13.18 | $13.80 | $19.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $32.36 Median $112.20 Typical High $120.23 | Facility | None | $32.36 | $112.20 | $120.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $18.20 Median $26.30 Typical High $89.13 | Professional | None | $18.20 | $26.30 | $89.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.34 Median $3.89 Typical High $17.38 | Professional | RR · Rental | $2.34 | $3.89 | $17.38 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $17.38 Median $28.84 Typical High $131.83 | Professional | UE · Used equipment | $17.38 | $28.84 | $131.83 |
CareSource Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Facility | None | $26.92 | $26.92 | $26.92 |
CareSource Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | None | $26.92 | $26.92 | $26.92 |
Cigna Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Facility | None | $25.12 | $25.12 | $25.12 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $43.65 | Professional | None | $21.38 | $21.38 | $43.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $22.91 Median $32.36 Typical High $229.09 | Professional | None | $22.91 | $32.36 | $229.09 |
United Setting Professional Modifier None Typical Low $10.96 Median $15.85 Typical High $40.74 | Professional | None | $10.96 | $15.85 | $40.74 |
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 $6.61 Median $6.92 Typical High $10.00 | Professional | 52 · Reduced service | $6.61 | $6.92 | $10.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.63 Median $2.82 Typical High $4.07 | Professional | 53 · Discontinued | $2.63 | $2.82 | $4.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.00 Median $2.09 Typical High $3.02 | Professional | 55 · Aftercare only | $2.00 | $2.09 | $3.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.32 Median $1.38 Typical High $2.04 | Professional | 56 · Pre-op care only | $1.32 | $1.38 | $2.04 |
Where Georgia sits
The same service costs 2.1 times more in Minnesota than in Washington, DC. 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
$25.70
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.