How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $120.23 | Facility | None | $114.82 | $114.82 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $120.23 | Professional | None | $114.82 | $114.82 | $120.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $114.82 Median $131.83 Typical High $660.69 | Professional | None | $114.82 | $131.83 | $660.69 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.75 Median $14.45 Typical High $66.07 | Professional | RR · Rental | $11.75 | $14.45 | $66.07 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $89.13 Median $109.65 Typical High $501.19 | Professional | UE · Used equipment | $89.13 | $109.65 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $117.49 Median $144.54 Typical High $229.09 | Professional | None | $117.49 | $144.54 | $229.09 |
United Setting Professional Modifier None Typical Low $47.86 Median $70.79 Typical High $100.00 | Professional | None | $47.86 | $70.79 | $100.00 |
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 $57.54 Median $57.54 Typical High $60.26 | Professional | 52 · Reduced service | $57.54 | $57.54 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $22.91 Typical High $23.99 | Professional | 53 · Discontinued | $22.91 | $22.91 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $17.38 Typical High $17.78 | Professional | 55 · Aftercare only | $17.38 | $17.38 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $12.02 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $12.02 |
Where Georgia sits
The same service costs 3.0 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
$126
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.