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 $1,071.52 Median $1,071.52 Typical High $1,513.56 | Facility | None | $1,071.52 | $1,071.52 | $1,513.56 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,445.44 | Professional | None | $1,071.52 | $1,071.52 | $1,445.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,344.23 Median $7,943.28 Typical High $8,511.38 | Facility | None | $2,344.23 | $7,943.28 | $8,511.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,995.26 Typical High $7,585.78 | Professional | None | $1,148.15 | $1,995.26 | $7,585.78 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $114.82 Median $257.04 Typical High $1,174.90 | Professional | RR · Rental | $114.82 | $257.04 | $1,174.90 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $851.14 Median $1,905.46 Typical High $8,709.64 | Professional | UE · Used equipment | $851.14 | $1,905.46 | $8,709.64 |
CareSource Setting Facility Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Facility | None | $1,949.84 | $1,949.84 | $1,949.84 |
CareSource Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,949.84 | $1,949.84 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | None | $1,174.90 | $1,174.90 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $3,090.30 | Professional | None | $851.14 | $851.14 | $3,090.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,621.81 Median $2,344.23 Typical High $3,311.31 | Professional | None | $1,621.81 | $2,344.23 | $3,311.31 |
United Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $933.25 | Facility | None | $870.96 | $870.96 | $933.25 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,122.02 Typical High $2,884.03 | Professional | None | $758.58 | $1,122.02 | $2,884.03 |
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 $537.03 Median $537.03 Typical High $724.44 | Professional | 52 · Reduced service | $537.03 | $537.03 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $288.40 | Professional | 53 · Discontinued | $213.80 | $213.80 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $213.80 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $144.54 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $144.54 |
Where Georgia sits
The same service costs 3.0 times more in Montana 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· 12th of 51
$1,905
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.