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 $77.62 Median $77.62 Typical High $81.28 | Facility | None | $77.62 | $77.62 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $77.62 Typical High $81.28 | Professional | None | $66.07 | $77.62 | $81.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $97.72 Median $338.84 Typical High $363.08 | Facility | None | $97.72 | $338.84 | $363.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $74.13 Median $89.13 Typical High $467.74 | Professional | None | $74.13 | $89.13 | $467.74 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $7.94 Median $10.23 Typical High $46.77 | Professional | RR · Rental | $7.94 | $10.23 | $46.77 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $60.26 Median $77.62 Typical High $346.74 | Professional | UE · Used equipment | $60.26 | $77.62 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $79.43 Median $97.72 Typical High $97.72 | Professional | None | $79.43 | $97.72 | $97.72 |
Oscar Health Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
United Setting Professional Modifier None Typical Low $32.36 Median $43.65 Typical High $66.07 | Professional | None | $32.36 | $43.65 | $66.07 |
7 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 $33.11 Median $38.90 Typical High $40.74 | Professional | 52 · Reduced service | $33.11 | $38.90 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $15.49 Typical High $16.22 | Professional | 53 · Discontinued | $13.18 | $15.49 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $11.48 Typical High $12.02 | Professional | 55 · Aftercare only | $10.00 | $11.48 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $7.76 Typical High $8.13 | Professional | 56 · Pre-op care only | $6.61 | $7.76 | $8.13 |
Oscar Health Setting Professional Modifier DS · Ambulance D to S Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | DS · Ambulance D to S | $15.14 | $15.14 | $15.14 |
Oscar Health Setting Professional Modifier FS · Shared visit Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | FS · Shared visit | $15.14 | $15.14 | $15.14 |
Oscar Health Setting Professional Modifier PR · Ambulance P to R Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | PR · Ambulance P to R | $15.14 | $15.14 | $15.14 |
Where Georgia sits
The same service costs 3.6 times more in Hawaii 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· 9th of 51
$85.11
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.