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 $537.03 Median $537.03 Typical High $741.31 | Facility | None | $537.03 | $537.03 | $741.31 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $1,412.54 | Professional | None | $537.03 | $676.08 | $1,412.54 |
Ambetter Setting Professional Modifier None Typical Low $575.44 Median $1,659.59 Typical High $1,659.59 | Professional | None | $575.44 | $1,659.59 | $1,659.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,148.15 Median $3,981.07 Typical High $4,168.69 | Facility | None | $1,148.15 | $3,981.07 | $4,168.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $616.60 Median $1,000.00 Typical High $3,715.35 | Professional | None | $616.60 | $1,000.00 | $3,715.35 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $61.66 Median $141.25 Typical High $630.96 | Professional | RR · Rental | $61.66 | $141.25 | $630.96 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $457.09 Median $1,047.13 Typical High $4,786.30 | Professional | UE · Used equipment | $457.09 | $1,047.13 | $4,786.30 |
CareSource Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Facility | None | $954.99 | $954.99 | $954.99 |
CareSource Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $776.25 | Facility | None | $707.95 | $707.95 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $1,548.82 | Professional | None | $512.86 | $512.86 | $1,548.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $794.33 Median $1,148.15 Typical High $1,621.81 | Professional | None | $794.33 | $1,148.15 | $1,621.81 |
United Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $691.83 | Facility | None | $478.63 | $478.63 | $691.83 |
United Setting Professional Modifier None Typical Low $371.54 Median $562.34 Typical High $1,445.44 | Professional | None | $371.54 | $562.34 | $1,445.44 |
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 $275.42 Typical High $354.81 | Professional | 52 · Reduced service | $269.15 | $275.42 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $109.65 Typical High $141.25 | Professional | 53 · Discontinued | $107.15 | $109.65 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $83.18 Typical High $107.15 | Professional | 55 · Aftercare only | $79.43 | $83.18 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $54.95 Typical High $70.79 | Professional | 56 · Pre-op care only | $53.70 | $54.95 | $70.79 |
Where Georgia sits
The same service costs 3.4 times more in Hawaii than in Mississippi. 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· 11th of 51
$933
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.