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 $562.34 Median $562.34 Typical High $794.33 | Facility | None | $562.34 | $562.34 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $724.44 Typical High $1,479.11 | Professional | None | $562.34 | $724.44 | $1,479.11 |
Ambetter Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,949.84 | Professional | None | $1,698.24 | $1,698.24 | $1,949.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $3,162.28 Typical High $3,388.44 | Facility | None | $933.25 | $3,162.28 | $3,388.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $794.33 Median $1,318.26 Typical High $3,548.13 | Professional | None | $794.33 | $1,318.26 | $3,548.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $79.43 Median $138.04 Typical High $380.19 | Professional | RR · Rental | $79.43 | $138.04 | $380.19 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $602.56 Median $870.96 Typical High $2,884.03 | Professional | UE · Used equipment | $602.56 | $870.96 | $2,884.03 |
CareSource Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
CareSource Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Facility | None | $851.14 | $851.14 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $1,230.27 | Professional | None | $616.60 | $616.60 | $1,230.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $912.01 Median $933.25 Typical High $1,819.70 | Professional | None | $912.01 | $933.25 | $1,819.70 |
United Setting Professional Modifier None Typical Low $549.54 Median $831.76 Typical High $1,258.93 | Professional | None | $549.54 | $831.76 | $1,258.93 |
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 $269.15 Median $281.84 Typical High $416.87 | Professional | 52 · Reduced service | $269.15 | $281.84 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $114.82 Typical High $169.82 | Professional | 53 · Discontinued | $109.65 | $114.82 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $85.11 Typical High $125.89 | Professional | 55 · Aftercare only | $81.28 | $85.11 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $56.23 Typical High $85.11 | Professional | 56 · Pre-op care only | $54.95 | $56.23 | $85.11 |
Where Georgia sits
The same service costs 2.8 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· 4th of 51
$1,148
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.