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 $1,348.96 Median $1,348.96 Typical High $1,905.46 | Facility | None | $1,348.96 | $1,348.96 | $1,905.46 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,819.70 | Professional | None | $1,348.96 | $1,348.96 | $1,819.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $10,000.00 Typical High $10,715.19 | Facility | None | $2,884.03 | $10,000.00 | $10,715.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,479.11 Median $2,511.89 Typical High $9,332.54 | Professional | None | $1,479.11 | $2,511.89 | $9,332.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $147.91 Median $323.59 Typical High $1,445.44 | Professional | RR · Rental | $147.91 | $323.59 | $1,445.44 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,122.02 Median $2,398.83 Typical High $10,964.78 | Professional | UE · Used equipment | $1,122.02 | $2,398.83 | $10,964.78 |
CareSource Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Facility | None | $2,398.83 | $2,398.83 | $2,398.83 |
CareSource Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,398.83 | $2,398.83 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,548.82 | $1,548.82 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $3,890.45 | Professional | None | $1,122.02 | $1,122.02 | $3,890.45 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,041.74 Median $2,884.03 Typical High $4,073.80 | Professional | None | $2,041.74 | $2,884.03 | $4,073.80 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,659.59 | Facility | None | $1,584.89 | $1,584.89 | $1,659.59 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,412.54 Typical High $3,630.78 | Professional | None | $954.99 | $1,412.54 | $3,630.78 |
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 $676.08 Median $676.08 Typical High $891.25 | Professional | 52 · Reduced service | $676.08 | $676.08 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $363.08 | Professional | 53 · Discontinued | $269.15 | $269.15 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $269.15 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $181.97 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $181.97 |
Where Georgia sits
The same service costs 3.1 times more in Hawaii than in Delaware. 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
$2,344
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.