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 $1,862.09 Median $1,862.09 Typical High $2,630.27 | Facility | None | $1,862.09 | $1,862.09 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,511.89 | Professional | None | $1,862.09 | $1,862.09 | $2,511.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,981.07 Median $13,803.84 Typical High $14,791.08 | Facility | None | $3,981.07 | $13,803.84 | $14,791.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,949.84 Median $3,467.37 Typical High $12,882.50 | Professional | None | $1,949.84 | $3,467.37 | $12,882.50 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $194.98 Median $436.52 Typical High $1,995.26 | Professional | RR · Rental | $194.98 | $436.52 | $1,995.26 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,479.11 Median $3,311.31 Typical High $15,135.61 | Professional | UE · Used equipment | $1,479.11 | $3,311.31 | $15,135.61 |
CareSource Setting Facility Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Facility | None | $3,311.31 | $3,311.31 | $3,311.31 |
CareSource Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Professional | None | $3,311.31 | $3,311.31 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Facility | None | $1,995.26 | $1,995.26 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $5,370.32 | Professional | None | $1,479.11 | $1,479.11 | $5,370.32 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,818.38 Median $3,981.07 Typical High $5,623.41 | Professional | None | $2,818.38 | $3,981.07 | $5,623.41 |
Oscar Health Setting Professional Modifier None Typical Low $3,548.13 Median $4,897.79 Typical High $7,079.46 | Professional | None | $3,548.13 | $4,897.79 | $7,079.46 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,951.21 | Facility | None | $2,137.96 | $2,137.96 | $2,951.21 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $1,949.84 Typical High $5,011.87 | Professional | None | $1,318.26 | $1,949.84 | $5,011.87 |
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 $933.25 Median $933.25 Typical High $1,258.93 | Professional | 52 · Reduced service | $933.25 | $933.25 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $371.54 Typical High $501.19 | Professional | 53 · Discontinued | $371.54 | $371.54 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $281.84 Typical High $371.54 | Professional | 55 · Aftercare only | $281.84 | $281.84 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $186.21 Typical High $251.19 | Professional | 56 · Pre-op care only | $186.21 | $186.21 | $251.19 |
Where Georgia sits
The same service costs 4.4 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· 10th of 51
$3,236
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.