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 $169.82 Median $169.82 Typical High $269.15 | Facility | None | $169.82 | $169.82 | $269.15 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $181.97 Typical High $269.15 | Professional | None | $169.82 | $181.97 | $269.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $338.84 Typical High $1,202.26 | Professional | None | $245.47 | $338.84 | $1,202.26 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $29.51 Median $54.95 Typical High $251.19 | Professional | RR · Rental | $29.51 | $54.95 | $251.19 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $223.87 Median $416.87 Typical High $1,862.09 | Professional | UE · Used equipment | $223.87 | $416.87 | $1,862.09 |
CareSource Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
CareSource Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $549.54 | Professional | None | $199.53 | $199.53 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $288.40 Median $416.87 Typical High $758.58 | Professional | None | $288.40 | $416.87 | $758.58 |
United Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
United Setting Professional Modifier None Typical Low $158.49 Median $199.53 Typical High $512.86 | Professional | None | $158.49 | $199.53 | $512.86 |
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 $85.11 Median $91.20 Typical High $134.90 | Professional | 52 · Reduced service | $85.11 | $91.20 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $36.31 Typical High $53.70 | Professional | 53 · Discontinued | $33.88 | $36.31 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $26.92 Typical High $40.74 | Professional | 55 · Aftercare only | $25.12 | $26.92 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $18.20 Typical High $26.92 | Professional | 56 · Pre-op care only | $16.98 | $18.20 | $26.92 |
Where Georgia sits
The same service costs 3.4 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· 14th of 51
$324
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.