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 $812.83 Median $812.83 Typical High $1,122.02 | Facility | None | $812.83 | $812.83 | $1,122.02 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,071.52 | Professional | None | $812.83 | $812.83 | $1,071.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $6,025.60 Typical High $6,309.57 | Facility | None | $1,737.80 | $6,025.60 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,513.56 Typical High $6,456.54 | Professional | None | $912.01 | $1,513.56 | $6,456.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $91.20 Median $204.17 Typical High $912.01 | Professional | RR · Rental | $91.20 | $204.17 | $912.01 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $676.08 Median $1,513.56 Typical High $6,918.31 | Professional | UE · Used equipment | $676.08 | $1,513.56 | $6,918.31 |
CareSource Setting Facility Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Facility | None | $1,445.44 | $1,445.44 | $1,445.44 |
CareSource Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Facility | None | $1,148.15 | $1,148.15 | $1,148.15 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $2,290.87 | Professional | None | $831.76 | $831.76 | $2,290.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,202.26 Median $1,737.80 Typical High $2,454.71 | Professional | None | $1,202.26 | $1,737.80 | $2,454.71 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,258.93 | Facility | None | $1,000.00 | $1,000.00 | $1,258.93 |
United Setting Professional Modifier None Typical Low $562.34 Median $851.14 Typical High $2,187.76 | Professional | None | $562.34 | $851.14 | $2,187.76 |
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 $398.11 Median $407.38 Typical High $537.03 | Professional | 52 · Reduced service | $398.11 | $407.38 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $213.80 | Professional | 53 · Discontinued | $162.18 | $162.18 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $123.03 Typical High $162.18 | Professional | 55 · Aftercare only | $120.23 | $123.03 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $107.15 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $107.15 |
Where Georgia sits
The same service costs 3.9 times more in Hawaii than in West Virginia. 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
$1,413
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.