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 $512.86 Median $512.86 Typical High $724.44 | Facility | None | $512.86 | $512.86 | $724.44 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $602.56 Typical High $1,071.52 | Professional | None | $512.86 | $602.56 | $1,071.52 |
Ambetter Setting Professional Modifier None Typical Low $426.58 Median $831.76 Typical High $831.76 | Professional | None | $426.58 | $831.76 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $3,801.89 Typical High $4,073.80 | Facility | None | $1,096.48 | $3,801.89 | $4,073.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $602.56 Median $954.99 Typical High $4,073.80 | Professional | None | $602.56 | $954.99 | $4,073.80 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $57.54 Median $131.83 Typical High $588.84 | Professional | RR · Rental | $57.54 | $131.83 | $588.84 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $436.52 Median $977.24 Typical High $4,466.84 | Professional | UE · Used equipment | $436.52 | $977.24 | $4,466.84 |
CareSource Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Facility | None | $912.01 | $912.01 | $912.01 |
CareSource Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | None | $912.01 | $912.01 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $851.14 | Facility | None | $724.44 | $724.44 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $1,479.11 | Professional | None | $537.03 | $537.03 | $1,479.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $776.25 Median $1,096.48 Typical High $1,548.82 | Professional | None | $776.25 | $1,096.48 | $1,548.82 |
United Setting Professional Modifier None Typical Low $363.08 Median $537.03 Typical High $1,380.38 | Professional | None | $363.08 | $537.03 | $1,380.38 |
2 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 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $102.33 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $52.48 Typical High $69.18 | Professional | 56 · Pre-op care only | $51.29 | $52.48 | $69.18 |
Where Georgia sits
The same service costs 2.0 times more in Montana 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· 13th of 51
$891
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.