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 $309.03 Median $309.03 Typical High $436.52 | Facility | None | $309.03 | $309.03 | $436.52 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $416.87 | Professional | None | $309.03 | $309.03 | $416.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $676.08 Median $2,344.23 Typical High $2,454.71 | Facility | None | $676.08 | $2,344.23 | $2,454.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $338.84 Median $588.84 Typical High $2,511.89 | Professional | None | $338.84 | $588.84 | $2,511.89 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $33.88 Median $75.86 Typical High $346.74 | Professional | RR · Rental | $33.88 | $75.86 | $346.74 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $257.04 Median $575.44 Typical High $2,570.40 | Professional | UE · Used equipment | $257.04 | $575.44 | $2,570.40 |
CareSource Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Facility | None | $562.34 | $562.34 | $562.34 |
CareSource Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $891.25 | Professional | None | $275.42 | $275.42 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $467.74 Median $676.08 Typical High $1,071.52 | Professional | None | $467.74 | $676.08 | $1,071.52 |
United Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $371.54 | Facility | None | $269.15 | $269.15 | $371.54 |
United Setting Professional Modifier None Typical Low $218.78 Median $331.13 Typical High $831.76 | Professional | None | $218.78 | $331.13 | $831.76 |
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 $154.88 Median $154.88 Typical High $208.93 | Professional | 52 · Reduced service | $154.88 | $154.88 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $83.18 | Professional | 53 · Discontinued | $63.10 | $63.10 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $46.77 Typical High $63.10 | Professional | 55 · Aftercare only | $46.77 | $46.77 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $30.90 Typical High $41.69 | Professional | 56 · Pre-op care only | $30.90 | $30.90 | $41.69 |
Where Georgia sits
The same service costs 3.0 times more in Hawaii than in Vermont. 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· 14th of 51
$550
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.