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 $302.00 Median $302.00 Typical High $426.58 | Facility | None | $302.00 | $302.00 | $426.58 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $309.03 Typical High $398.11 | Professional | None | $302.00 | $309.03 | $398.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $645.65 Median $2,238.72 Typical High $2,398.83 | Facility | None | $645.65 | $2,238.72 | $2,398.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $338.84 Median $562.34 Typical High $2,089.30 | Professional | None | $338.84 | $562.34 | $2,089.30 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $33.88 Median $75.86 Typical High $346.74 | Professional | RR · Rental | $33.88 | $75.86 | $346.74 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $257.04 Median $575.44 Typical High $2,570.40 | Professional | UE · Used equipment | $257.04 | $575.44 | $2,570.40 |
CareSource Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
CareSource Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $870.96 | Professional | None | $309.03 | $309.03 | $870.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $457.09 Median $645.65 Typical High $912.01 | Professional | None | $457.09 | $645.65 | $912.01 |
United Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $371.54 | Facility | None | $363.08 | $363.08 | $371.54 |
United Setting Professional Modifier None Typical Low $208.93 Median $316.23 Typical High $812.83 | Professional | None | $208.93 | $316.23 | $812.83 |
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 $151.36 Median $154.88 Typical High $199.53 | Professional | 52 · Reduced service | $151.36 | $154.88 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $61.66 Typical High $79.43 | Professional | 53 · Discontinued | $60.26 | $61.66 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $45.71 Typical High $60.26 | Professional | 55 · Aftercare only | $44.67 | $45.71 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.90 Typical High $39.81 | Professional | 56 · Pre-op care only | $30.20 | $30.90 | $39.81 |
Where Georgia sits
The same service costs 2.9 times more in Hawaii than in Washington, DC. 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· 12th of 51
$525
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.