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 $457.09 Median $457.09 Typical High $630.96 | Facility | None | $457.09 | $457.09 | $630.96 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $602.56 | Professional | None | $457.09 | $457.09 | $602.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $977.24 Median $3,388.44 Typical High $3,548.13 | Facility | None | $977.24 | $3,388.44 | $3,548.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $794.33 Typical High $2,754.23 | Professional | None | $489.78 | $794.33 | $2,754.23 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $48.98 Median $112.20 Typical High $512.86 | Professional | RR · Rental | $48.98 | $112.20 | $512.86 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $363.08 Median $831.76 Typical High $3,801.89 | Professional | UE · Used equipment | $363.08 | $831.76 | $3,801.89 |
CareSource Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Facility | None | $812.83 | $812.83 | $812.83 |
CareSource Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $1,288.25 | Professional | None | $371.54 | $371.54 | $1,288.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $977.24 Typical High $1,380.38 | Professional | None | $676.08 | $977.24 | $1,380.38 |
United Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $549.54 | Facility | None | $478.63 | $478.63 | $549.54 |
United Setting Professional Modifier None Typical Low $316.23 Median $478.63 Typical High $1,230.27 | Professional | None | $316.23 | $478.63 | $1,230.27 |
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 $223.87 Median $223.87 Typical High $302.00 | Professional | 52 · Reduced service | $223.87 | $223.87 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $120.23 | Professional | 53 · Discontinued | $91.20 | $91.20 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $91.20 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $60.26 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $60.26 |
Where Georgia sits
The same service costs 3.2 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· 16th of 51
$692
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.