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 $676.08 Median $676.08 Typical High $954.99 | Facility | None | $676.08 | $676.08 | $954.99 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $870.96 Typical High $1,778.28 | Professional | None | $676.08 | $870.96 | $1,778.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $5,128.61 Typical High $5,370.32 | Facility | None | $1,479.11 | $5,128.61 | $5,370.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $794.33 Median $1,288.25 Typical High $4,786.30 | Professional | None | $794.33 | $1,288.25 | $4,786.30 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $83.18 Median $169.82 Typical High $776.25 | Professional | RR · Rental | $83.18 | $169.82 | $776.25 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $616.60 Median $1,288.25 Typical High $5,888.44 | Professional | UE · Used equipment | $616.60 | $1,288.25 | $5,888.44 |
CareSource Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,230.27 | $1,230.27 | $1,230.27 |
CareSource Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Facility | None | $831.76 | $831.76 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $1,949.84 | Professional | None | $616.60 | $616.60 | $1,949.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,023.29 Median $1,479.11 Typical High $2,089.30 | Professional | None | $1,023.29 | $1,479.11 | $2,089.30 |
Oscar Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,949.84 Typical High $2,398.83 | Professional | None | $1,445.44 | $1,949.84 | $2,398.83 |
United Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $794.33 | Facility | None | $630.96 | $630.96 | $794.33 |
United Setting Professional Modifier None Typical Low $478.63 Median $724.44 Typical High $1,862.09 | Professional | None | $478.63 | $724.44 | $1,862.09 |
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 $338.84 Median $346.74 Typical High $457.09 | Professional | 52 · Reduced service | $338.84 | $346.74 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $181.97 | Professional | 53 · Discontinued | $138.04 | $138.04 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $104.71 Typical High $138.04 | Professional | 55 · Aftercare only | $102.33 | $104.71 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $69.18 Typical High $91.20 | Professional | 56 · Pre-op care only | $67.61 | $69.18 | $91.20 |
Where Georgia sits
The same service costs 3.2 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· 12th of 51
$1,202
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.