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 $562.34 Median $562.34 Typical High $794.33 | Facility | None | $562.34 | $562.34 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $588.84 Typical High $794.33 | Professional | None | $562.34 | $588.84 | $794.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $4,168.69 Typical High $4,466.84 | Facility | None | $1,202.26 | $4,168.69 | $4,466.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $1,047.13 Typical High $3,890.45 | Professional | None | $660.69 | $1,047.13 | $3,890.45 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $70.79 Median $158.49 Typical High $724.44 | Professional | RR · Rental | $70.79 | $158.49 | $724.44 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $537.03 Median $1,202.26 Typical High $5,495.41 | Professional | UE · Used equipment | $537.03 | $1,202.26 | $5,495.41 |
CareSource Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Facility | None | $1,000.00 | $1,000.00 | $1,000.00 |
CareSource Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Facility | None | $741.31 | $741.31 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $1,621.81 | Professional | None | $537.03 | $537.03 | $1,621.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $851.14 Median $1,202.26 Typical High $1,698.24 | Professional | None | $851.14 | $1,202.26 | $1,698.24 |
Oscar Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,584.89 | Professional | None | $1,380.38 | $1,380.38 | $1,584.89 |
United Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $912.01 | Facility | None | $776.25 | $776.25 | $912.01 |
United Setting Professional Modifier None Typical Low $398.11 Median $588.84 Typical High $1,513.56 | Professional | None | $398.11 | $588.84 | $1,513.56 |
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 $281.84 Median $295.12 Typical High $371.54 | Professional | 52 · Reduced service | $281.84 | $295.12 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $117.49 Typical High $147.91 | Professional | 53 · Discontinued | $112.20 | $117.49 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $87.10 Typical High $112.20 | Professional | 55 · Aftercare only | $83.18 | $87.10 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $58.88 Typical High $74.13 | Professional | 56 · Pre-op care only | $56.23 | $58.88 | $74.13 |
Where Georgia sits
The same service costs 4.6 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· 15th of 51
$977
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.