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 $407.38 Median $407.38 Typical High $575.44 | Facility | None | $407.38 | $407.38 | $575.44 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $426.58 Typical High $549.54 | Professional | None | $407.38 | $426.58 | $549.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $870.96 Median $3,019.95 Typical High $3,235.94 | Facility | None | $870.96 | $3,019.95 | $3,235.94 |
Anthem BCBS Setting Professional Modifier None Typical Low $478.63 Median $724.44 Typical High $2,454.71 | Professional | None | $478.63 | $724.44 | $2,454.71 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $48.98 Median $109.65 Typical High $501.19 | Professional | RR · Rental | $48.98 | $109.65 | $501.19 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $363.08 Median $812.83 Typical High $3,715.35 | Professional | UE · Used equipment | $363.08 | $812.83 | $3,715.35 |
CareSource Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Facility | None | $724.44 | $724.44 | $724.44 |
CareSource Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $1,174.90 | Professional | None | $363.08 | $363.08 | $1,174.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $616.60 Median $870.96 Typical High $1,258.93 | Professional | None | $616.60 | $870.96 | $1,258.93 |
United Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $562.34 | Facility | None | $537.03 | $537.03 | $562.34 |
United Setting Professional Modifier None Typical Low $288.40 Median $426.58 Typical High $1,096.48 | Professional | None | $288.40 | $426.58 | $1,096.48 |
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 $204.17 Median $213.80 Typical High $275.42 | Professional | 52 · Reduced service | $204.17 | $213.80 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $85.11 Typical High $109.65 | Professional | 53 · Discontinued | $81.28 | $85.11 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $63.10 Typical High $81.28 | Professional | 55 · Aftercare only | $61.66 | $63.10 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $42.66 Typical High $54.95 | Professional | 56 · Pre-op care only | $40.74 | $42.66 | $54.95 |
Where Georgia sits
The same service costs 3.9 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· 17th of 51
$631
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.