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 $851.14 Median $851.14 Typical High $1,174.90 | Facility | None | $851.14 | $851.14 | $1,174.90 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,122.02 | Professional | None | $851.14 | $851.14 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $6,309.57 Typical High $6,606.93 | Facility | None | $1,819.70 | $6,309.57 | $6,606.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $831.76 Median $1,479.11 Typical High $5,128.61 | Professional | None | $831.76 | $1,479.11 | $5,128.61 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $83.18 Median $186.21 Typical High $851.14 | Professional | RR · Rental | $83.18 | $186.21 | $851.14 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $616.60 Median $1,412.54 Typical High $6,456.54 | Professional | UE · Used equipment | $616.60 | $1,412.54 | $6,456.54 |
CareSource Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Facility | None | $1,513.56 | $1,513.56 | $1,513.56 |
CareSource Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $2,454.71 | Professional | None | $645.65 | $645.65 | $2,454.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,258.93 Median $1,819.70 Typical High $2,570.40 | Professional | None | $1,258.93 | $1,819.70 | $2,570.40 |
United Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $870.96 | Facility | None | $851.14 | $851.14 | $870.96 |
United Setting Professional Modifier None Typical Low $588.84 Median $891.25 Typical High $2,290.87 | Professional | None | $588.84 | $891.25 | $2,290.87 |
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 $426.58 Median $426.58 Typical High $562.34 | Professional | 52 · Reduced service | $426.58 | $426.58 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $223.87 | Professional | 53 · Discontinued | $169.82 | $169.82 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $169.82 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $112.20 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $112.20 |
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· 13th 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.