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 $251.19 Median $251.19 Typical High $354.81 | Facility | None | $251.19 | $251.19 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $257.04 Typical High $338.84 | Professional | None | $251.19 | $257.04 | $338.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $537.03 Median $1,862.09 Typical High $1,995.26 | Facility | None | $537.03 | $1,862.09 | $1,995.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $295.12 Median $467.74 Typical High $2,041.74 | Professional | None | $295.12 | $467.74 | $2,041.74 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $30.20 Median $67.61 Typical High $309.03 | Professional | RR · Rental | $30.20 | $67.61 | $309.03 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $223.87 Median $501.19 Typical High $2,290.87 | Professional | UE · Used equipment | $223.87 | $501.19 | $2,290.87 |
CareSource Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
CareSource Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $724.44 | Professional | None | $281.84 | $281.84 | $724.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $380.19 Median $537.03 Typical High $776.25 | Professional | None | $380.19 | $537.03 | $776.25 |
United Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $426.58 | Facility | None | $331.13 | $331.13 | $426.58 |
United Setting Professional Modifier None Typical Low $177.83 Median $263.03 Typical High $676.08 | Professional | None | $177.83 | $263.03 | $676.08 |
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 $125.89 Median $128.82 Typical High $169.82 | Professional | 52 · Reduced service | $125.89 | $128.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $51.29 Typical High $67.61 | Professional | 53 · Discontinued | $50.12 | $51.29 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $38.90 Typical High $50.12 | Professional | 55 · Aftercare only | $38.02 | $38.90 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $25.70 Typical High $33.88 | Professional | 56 · Pre-op care only | $25.12 | $25.70 | $33.88 |
Where Georgia sits
The same service costs 3.4 times more in Hawaii than in Washington, DC. 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· 16th of 51
$437
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.