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 $223.87 Median $223.87 Typical High $316.23 | Facility | None | $223.87 | $223.87 | $316.23 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $234.42 Typical High $309.03 | Professional | None | $223.87 | $234.42 | $309.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $489.78 Median $1,698.24 Typical High $1,778.28 | Facility | None | $489.78 | $1,698.24 | $1,778.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $263.03 Median $426.58 Typical High $2,951.21 | Professional | None | $263.03 | $426.58 | $2,951.21 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $28.84 Median $64.57 Typical High $295.12 | Professional | RR · Rental | $28.84 | $64.57 | $295.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $218.78 Median $489.78 Typical High $2,238.72 | Professional | UE · Used equipment | $218.78 | $489.78 | $2,238.72 |
CareSource Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
CareSource Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $645.65 | Professional | None | $218.78 | $218.78 | $645.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $338.84 Median $489.78 Typical High $741.31 | Professional | None | $338.84 | $489.78 | $741.31 |
United Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $346.74 | Facility | None | $316.23 | $316.23 | $346.74 |
United Setting Professional Modifier None Typical Low $162.18 Median $239.88 Typical High $602.56 | Professional | None | $162.18 | $239.88 | $602.56 |
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 $112.20 Median $117.49 Typical High $154.88 | Professional | 52 · Reduced service | $112.20 | $117.49 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $46.77 Typical High $63.10 | Professional | 53 · Discontinued | $45.71 | $46.77 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $35.48 Typical High $47.86 | Professional | 55 · Aftercare only | $33.88 | $35.48 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $23.44 Typical High $31.62 | Professional | 56 · Pre-op care only | $22.39 | $23.44 | $31.62 |
Where Georgia sits
The same service costs 4.2 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
$398
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.