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 $1,000.00 Median $1,000.00 Typical High $1,380.38 | Facility | None | $1,000.00 | $1,000.00 | $1,380.38 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,023.29 Typical High $1,348.96 | Professional | None | $1,000.00 | $1,023.29 | $1,348.96 |
Ambetter Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $7,413.10 Typical High $7,762.47 | Facility | None | $2,137.96 | $7,413.10 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $1,737.80 Typical High $6,025.60 | Professional | None | $1,174.90 | $1,737.80 | $6,025.60 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $125.89 Median $281.84 Typical High $1,288.25 | Professional | RR · Rental | $125.89 | $281.84 | $1,288.25 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $954.99 Median $2,137.96 Typical High $9,772.37 | Professional | UE · Used equipment | $954.99 | $2,137.96 | $9,772.37 |
CareSource Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Facility | None | $1,778.28 | $1,778.28 | $1,778.28 |
CareSource Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $2,884.03 | Professional | None | $954.99 | $954.99 | $2,884.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,479.11 Median $2,137.96 Typical High $3,235.94 | Professional | None | $1,479.11 | $2,137.96 | $3,235.94 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,258.93 | Facility | None | $1,122.02 | $1,122.02 | $1,258.93 |
United Setting Professional Modifier None Typical Low $707.95 Median $1,047.13 Typical High $2,691.53 | Professional | None | $707.95 | $1,047.13 | $2,691.53 |
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 $501.19 Median $512.86 Typical High $676.08 | Professional | 52 · Reduced service | $501.19 | $512.86 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $204.17 Typical High $269.15 | Professional | 53 · Discontinued | $199.53 | $204.17 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $154.88 Typical High $199.53 | Professional | 55 · Aftercare only | $147.91 | $154.88 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $102.33 Typical High $134.90 | Professional | 56 · Pre-op care only | $100.00 | $102.33 | $134.90 |
Where Georgia sits
The same service costs 2.9 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· 22nd of 51
$1,514
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.