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 $630.96 Median $630.96 Typical High $870.96 | Facility | None | $630.96 | $630.96 | $870.96 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $645.65 Typical High $831.76 | Professional | None | $630.96 | $645.65 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,348.96 Median $4,677.35 Typical High $4,897.79 | Facility | None | $1,348.96 | $4,677.35 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $1,096.48 Typical High $3,801.89 | Professional | None | $741.31 | $1,096.48 | $3,801.89 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $79.43 Median $177.83 Typical High $812.83 | Professional | RR · Rental | $79.43 | $177.83 | $812.83 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $588.84 Median $1,348.96 Typical High $6,165.95 | Professional | UE · Used equipment | $588.84 | $1,348.96 | $6,165.95 |
CareSource Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Facility | None | $1,122.02 | $1,122.02 | $1,122.02 |
CareSource Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,122.02 | $1,122.02 | $1,122.02 |
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 $602.56 Median $602.56 Typical High $1,778.28 | Professional | None | $602.56 | $602.56 | $1,778.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $933.25 Median $1,348.96 Typical High $2,041.74 | Professional | None | $933.25 | $1,348.96 | $2,041.74 |
United Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $1,348.96 | Facility | None | $870.96 | $870.96 | $1,348.96 |
United Setting Professional Modifier None Typical Low $446.68 Median $660.69 Typical High $1,698.24 | Professional | None | $446.68 | $660.69 | $1,698.24 |
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 $309.03 Median $323.59 Typical High $416.87 | Professional | 52 · Reduced service | $309.03 | $323.59 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $128.82 Typical High $165.96 | Professional | 53 · Discontinued | $125.89 | $128.82 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $97.72 Typical High $125.89 | Professional | 55 · Aftercare only | $93.33 | $97.72 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $64.57 Typical High $83.18 | Professional | 56 · Pre-op care only | $63.10 | $64.57 | $83.18 |
Where Georgia sits
The same service costs 5.4 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· 18th of 51
$955
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.