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 $331.13 Median $331.13 Typical High $467.74 | Facility | None | $331.13 | $331.13 | $467.74 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $338.84 Typical High $446.68 | Professional | None | $331.13 | $338.84 | $446.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $2,454.71 Typical High $2,630.27 | Facility | None | $724.44 | $2,454.71 | $2,630.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $588.84 Typical High $2,041.74 | Professional | None | $380.19 | $588.84 | $2,041.74 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $38.02 Median $89.13 Typical High $407.38 | Professional | RR · Rental | $38.02 | $89.13 | $407.38 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $288.40 Median $660.69 Typical High $3,019.95 | Professional | UE · Used equipment | $288.40 | $660.69 | $3,019.95 |
CareSource Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
CareSource Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $954.99 | Professional | None | $295.12 | $295.12 | $954.99 |
Kaiser Permanente Setting Professional Modifier None Typical Low $501.19 Median $724.44 Typical High $1,023.29 | Professional | None | $501.19 | $724.44 | $1,023.29 |
United Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $575.44 | Facility | None | $436.52 | $436.52 | $575.44 |
United Setting Professional Modifier None Typical Low $234.42 Median $354.81 Typical High $891.25 | Professional | None | $234.42 | $354.81 | $891.25 |
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 $165.96 Median $169.82 Typical High $223.87 | Professional | 52 · Reduced service | $165.96 | $169.82 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $67.61 Typical High $89.13 | Professional | 53 · Discontinued | $66.07 | $67.61 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $51.29 Typical High $66.07 | Professional | 55 · Aftercare only | $50.12 | $51.29 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.88 Typical High $44.67 | Professional | 56 · Pre-op care only | $33.11 | $33.88 | $44.67 |
Where Georgia sits
The same service costs 4.3 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
$513
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.