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 $223.87 Median $223.87 Typical High $316.23 | Facility | None | $223.87 | $223.87 | $316.23 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $223.87 Typical High $316.23 | Professional | None | $213.80 | $223.87 | $316.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $1,318.26 Typical High $1,412.54 | Facility | None | $389.05 | $1,318.26 | $1,412.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $467.74 Typical High $1,380.38 | Professional | None | $331.13 | $467.74 | $1,380.38 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $33.11 Median $47.86 Typical High $158.49 | Professional | RR · Rental | $33.11 | $47.86 | $158.49 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $245.47 Median $363.08 Typical High $1,202.26 | Professional | UE · Used equipment | $245.47 | $363.08 | $1,202.26 |
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 $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $512.86 | Professional | None | $281.84 | $281.84 | $512.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $338.84 Median $389.05 Typical High $933.25 | Professional | None | $338.84 | $389.05 | $933.25 |
United Setting Professional Modifier None Typical Low $194.98 Median $288.40 Typical High $478.63 | Professional | None | $194.98 | $288.40 | $478.63 |
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 $107.15 Median $112.20 Typical High $158.49 | Professional | 52 · Reduced service | $107.15 | $112.20 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $44.67 Typical High $63.10 | Professional | 53 · Discontinued | $42.66 | $44.67 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $33.88 Typical High $47.86 | Professional | 55 · Aftercare only | $32.36 | $33.88 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $22.39 Typical High $31.62 | Professional | 56 · Pre-op care only | $21.38 | $22.39 | $31.62 |
Where Georgia sits
The same service costs 3.0 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· 6th of 51
$407
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.