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 $27.54 Median $27.54 Typical High $28.84 | Facility | None | $27.54 | $27.54 | $28.84 |
Aetna Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $28.84 | Professional | None | $27.54 | $27.54 | $28.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $34.67 Median $120.23 Typical High $128.82 | Facility | None | $34.67 | $120.23 | $128.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.30 Median $31.62 Typical High $213.80 | Professional | None | $26.30 | $31.62 | $213.80 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.82 Median $4.68 Typical High $21.38 | Professional | RR · Rental | $2.82 | $4.68 | $21.38 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $21.38 Median $33.11 Typical High $158.49 | Professional | UE · Used equipment | $21.38 | $33.11 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | None | $16.60 | $16.60 | $16.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $28.18 Median $34.67 Typical High $35.48 | Professional | None | $28.18 | $34.67 | $35.48 |
Oscar Health Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
United Setting Professional Modifier None Typical Low $11.48 Median $15.49 Typical High $28.18 | Professional | None | $11.48 | $15.49 | $28.18 |
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 $13.80 Median $13.80 Typical High $14.13 | Professional | 52 · Reduced service | $13.80 | $13.80 | $14.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $5.50 Typical High $5.75 | Professional | 53 · Discontinued | $5.50 | $5.50 | $5.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $4.07 Typical High $4.27 | Professional | 55 · Aftercare only | $4.07 | $4.07 | $4.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $2.75 Typical High $2.88 | Professional | 56 · Pre-op care only | $2.75 | $2.75 | $2.88 |
Where Georgia sits
The same service costs 5.9 times more in Hawaii than in Utah. 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
$30.20
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.