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 $436.52 Median $436.52 Typical High $602.56 | Facility | None | $436.52 | $436.52 | $602.56 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $537.03 Typical High $630.96 | Professional | None | $436.52 | $537.03 | $630.96 |
Ambetter Setting Professional Modifier None Typical Low $933.25 Median $1,348.96 Typical High $1,348.96 | Professional | None | $933.25 | $1,348.96 | $1,348.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $3,235.94 Typical High $3,388.44 | Facility | None | $933.25 | $3,235.94 | $3,388.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $338.84 Median $812.83 Typical High $3,019.95 | Professional | None | $338.84 | $812.83 | $3,019.95 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $33.11 Median $93.33 Typical High $426.58 | Professional | RR · Rental | $33.11 | $93.33 | $426.58 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $199.53 Median $691.83 Typical High $3,162.28 | Professional | UE · Used equipment | $199.53 | $691.83 | $3,162.28 |
CareSource Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
CareSource Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | None | $776.25 | $776.25 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $1,258.93 | Professional | None | $338.84 | $338.84 | $1,258.93 |
Cigna Setting Professional Modifier RR · Rental Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | RR · Rental | $45.71 | $45.71 | $45.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $645.65 Median $933.25 Typical High $1,318.26 | Professional | None | $645.65 | $933.25 | $1,318.26 |
Oscar Health Setting Professional Modifier None Typical Low $851.14 Median $1,174.90 Typical High $1,412.54 | Professional | None | $851.14 | $1,174.90 | $1,412.54 |
United Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
United Setting Professional Modifier None Typical Low $302.00 Median $457.09 Typical High $1,174.90 | Professional | None | $302.00 | $457.09 | $1,174.90 |
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 $218.78 Median $218.78 Typical High $288.40 | Professional | 52 · Reduced service | $218.78 | $218.78 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $87.10 Typical High $114.82 | Professional | 53 · Discontinued | $87.10 | $87.10 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $64.57 Typical High $87.10 | Professional | 55 · Aftercare only | $64.57 | $64.57 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $57.54 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $57.54 |
Where Georgia sits
The same service costs 2.6 times more in Hawaii than in New Hampshire. 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· 4th of 51
$759
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.