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 $1,230.27 Median $1,230.27 Typical High $1,737.80 | Facility | None | $1,230.27 | $1,230.27 | $1,737.80 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,659.59 | Professional | None | $1,230.27 | $1,230.27 | $1,659.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,630.27 Median $9,120.11 Typical High $9,772.37 | Facility | None | $2,630.27 | $9,120.11 | $9,772.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $2,290.87 Typical High $8,511.38 | Professional | None | $1,380.38 | $2,290.87 | $8,511.38 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $138.04 Median $309.03 Typical High $1,412.54 | Professional | RR · Rental | $138.04 | $309.03 | $1,412.54 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,047.13 Median $2,344.23 Typical High $10,715.19 | Professional | UE · Used equipment | $1,047.13 | $2,344.23 | $10,715.19 |
CareSource Setting Facility Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Facility | None | $2,238.72 | $2,238.72 | $2,238.72 |
CareSource Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | None | $2,238.72 | $2,238.72 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Facility | None | $1,698.24 | $1,698.24 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $3,548.13 | Professional | None | $1,230.27 | $1,230.27 | $3,548.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,862.09 Median $2,630.27 Typical High $3,801.89 | Professional | None | $1,862.09 | $2,630.27 | $3,801.89 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Facility | None | $1,513.56 | $1,513.56 | $1,513.56 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,288.25 Typical High $3,311.31 | Professional | None | $870.96 | $1,288.25 | $3,311.31 |
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 $616.60 Median $616.60 Typical High $831.76 | Professional | 52 · Reduced service | $616.60 | $616.60 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $331.13 | Professional | 53 · Discontinued | $245.47 | $245.47 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $245.47 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $165.96 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $165.96 |
Where Georgia sits
The same service costs 2.8 times more in Hawaii than in Arizona. 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· 10th of 51
$2,188
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.