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 $602.56 Median $602.56 Typical High $851.14 | Facility | None | $602.56 | $602.56 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $630.96 Typical High $831.76 | Professional | None | $602.56 | $630.96 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $4,466.84 Typical High $4,786.30 | Facility | None | $1,288.25 | $4,466.84 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $1,122.02 Typical High $4,168.69 | Professional | None | $707.95 | $1,122.02 | $4,168.69 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $77.62 Median $173.78 Typical High $794.33 | Professional | RR · Rental | $77.62 | $173.78 | $794.33 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $575.44 Median $1,288.25 Typical High $5,888.44 | Professional | UE · Used equipment | $575.44 | $1,288.25 | $5,888.44 |
CareSource Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Facility | None | $1,096.48 | $1,096.48 | $1,096.48 |
CareSource Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Facility | None | $1,047.13 | $1,047.13 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,737.80 | Professional | None | $776.25 | $776.25 | $1,737.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $912.01 Median $1,288.25 Typical High $1,995.26 | Professional | None | $912.01 | $1,288.25 | $1,995.26 |
United Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $977.24 | Facility | None | $851.14 | $851.14 | $977.24 |
United Setting Professional Modifier None Typical Low $426.58 Median $630.96 Typical High $1,621.81 | Professional | None | $426.58 | $630.96 | $1,621.81 |
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 $302.00 Median $316.23 Typical High $416.87 | Professional | 52 · Reduced service | $302.00 | $316.23 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $125.89 Typical High $169.82 | Professional | 53 · Discontinued | $120.23 | $125.89 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $95.50 Typical High $125.89 | Professional | 55 · Aftercare only | $91.20 | $95.50 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $63.10 Typical High $83.18 | Professional | 56 · Pre-op care only | $60.26 | $63.10 | $83.18 |
Where Georgia sits
The same service costs 3.5 times more in Hawaii than in Florida. 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· 16th of 51
$1,072
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.