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 $724.44 Median $724.44 Typical High $1,023.29 | Facility | None | $724.44 | $724.44 | $1,023.29 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $741.31 Typical High $977.24 | Professional | None | $724.44 | $741.31 | $977.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,548.82 Median $5,370.32 Typical High $5,754.40 | Facility | None | $1,548.82 | $5,370.32 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $794.33 Median $1,348.96 Typical High $5,011.87 | Professional | None | $794.33 | $1,348.96 | $5,011.87 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $79.43 Median $181.97 Typical High $831.76 | Professional | RR · Rental | $79.43 | $181.97 | $831.76 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $588.84 Median $1,380.38 Typical High $6,309.57 | Professional | UE · Used equipment | $588.84 | $1,380.38 | $6,309.57 |
CareSource Setting Facility Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Facility | None | $1,288.25 | $1,288.25 | $1,288.25 |
CareSource Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Facility | None | $851.14 | $851.14 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $2,089.30 | Professional | None | $616.60 | $616.60 | $2,089.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,096.48 Median $1,548.82 Typical High $2,238.72 | Professional | None | $1,096.48 | $1,548.82 | $2,238.72 |
United Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $776.25 | Facility | None | $630.96 | $630.96 | $776.25 |
United Setting Professional Modifier None Typical Low $512.86 Median $758.58 Typical High $1,949.84 | Professional | None | $512.86 | $758.58 | $1,949.84 |
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 $363.08 Median $371.54 Typical High $489.78 | Professional | 52 · Reduced service | $363.08 | $371.54 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $147.91 Typical High $194.98 | Professional | 53 · Discontinued | $144.54 | $147.91 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $112.20 Typical High $144.54 | Professional | 55 · Aftercare only | $109.65 | $112.20 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $74.13 Typical High $97.72 | Professional | 56 · Pre-op care only | $72.44 | $74.13 | $97.72 |
Where Georgia sits
The same service costs 3.0 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· 10th of 51
$1,288
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.