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 $467.74 Median $467.74 Typical High $660.69 | Facility | None | $467.74 | $467.74 | $660.69 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $588.84 Typical High $1,230.27 | Professional | None | $467.74 | $588.84 | $1,230.27 |
Ambetter Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $1,023.29 | Professional | None | $645.65 | $645.65 | $1,023.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $2,754.23 Typical High $2,951.21 | Facility | None | $794.33 | $2,754.23 | $2,951.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $1,000.00 Typical High $2,951.21 | Professional | None | $707.95 | $1,000.00 | $2,951.21 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $70.79 Median $102.33 Typical High $331.13 | Professional | RR · Rental | $70.79 | $102.33 | $331.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $537.03 Median $776.25 Typical High $2,454.71 | Professional | UE · Used equipment | $537.03 | $776.25 | $2,454.71 |
CareSource Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
CareSource Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Facility | None | $758.58 | $758.58 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $1,047.13 | Professional | None | $549.54 | $549.54 | $1,047.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $724.44 Median $794.33 Typical High $1,621.81 | Professional | None | $724.44 | $794.33 | $1,621.81 |
United Setting Professional Modifier None Typical Low $416.87 Median $616.60 Typical High $1,023.29 | Professional | None | $416.87 | $616.60 | $1,023.29 |
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 $223.87 Median $234.42 Typical High $338.84 | Professional | 52 · Reduced service | $223.87 | $234.42 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $93.33 Typical High $134.90 | Professional | 53 · Discontinued | $89.13 | $93.33 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $70.79 Typical High $100.00 | Professional | 55 · Aftercare only | $67.61 | $70.79 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $46.77 Typical High $67.61 | Professional | 56 · Pre-op care only | $44.67 | $46.77 | $67.61 |
Where Georgia sits
The same service costs 2.6 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· 8th of 51
$871
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.