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 $181.97 Median $181.97 Typical High $295.12 | Facility | None | $181.97 | $181.97 | $295.12 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $190.55 Typical High $275.42 | Professional | None | $181.97 | $190.55 | $275.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $257.04 Median $363.08 Typical High $1,288.25 | Professional | None | $257.04 | $363.08 | $1,288.25 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $32.36 Median $57.54 Typical High $263.03 | Professional | RR · Rental | $32.36 | $57.54 | $263.03 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $239.88 Median $426.58 Typical High $1,949.84 | Professional | UE · Used equipment | $239.88 | $426.58 | $1,949.84 |
CareSource Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
CareSource Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $602.56 | Professional | None | $316.23 | $316.23 | $602.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $316.23 Median $446.68 Typical High $676.08 | Professional | None | $316.23 | $446.68 | $676.08 |
United Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
United Setting Professional Modifier None Typical Low $165.96 Median $218.78 Typical High $562.34 | Professional | None | $165.96 | $218.78 | $562.34 |
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 $91.20 Median $97.72 Typical High $138.04 | Professional | 52 · Reduced service | $91.20 | $97.72 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $38.90 Typical High $54.95 | Professional | 53 · Discontinued | $36.31 | $38.90 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $28.84 Typical High $41.69 | Professional | 55 · Aftercare only | $27.54 | $28.84 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $19.50 Typical High $27.54 | Professional | 56 · Pre-op care only | $18.20 | $19.50 | $27.54 |
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
$363
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.