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 $1,380.38 Median $1,380.38 Typical High $2,187.76 | Facility | None | $1,380.38 | $1,380.38 | $2,187.76 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,479.11 Typical High $2,187.76 | Professional | None | $1,380.38 | $1,479.11 | $2,187.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,388.44 Median $11,748.98 Typical High $12,302.69 | Facility | None | $3,388.44 | $11,748.98 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,862.09 Median $2,884.03 Typical High $10,964.78 | Professional | None | $1,862.09 | $2,884.03 | $10,964.78 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $199.53 Median $446.68 Typical High $2,041.74 | Professional | RR · Rental | $199.53 | $446.68 | $2,041.74 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,479.11 Median $3,388.44 Typical High $15,488.17 | Professional | UE · Used equipment | $1,479.11 | $3,388.44 | $15,488.17 |
CareSource Setting Facility Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Facility | None | $2,818.38 | $2,818.38 | $2,818.38 |
CareSource Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,818.38 | $2,818.38 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Facility | None | $2,454.71 | $2,454.71 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $4,570.88 | Professional | None | $1,819.70 | $1,819.70 | $4,570.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,344.23 Median $3,388.44 Typical High $4,786.30 | Professional | None | $2,344.23 | $3,388.44 | $4,786.30 |
United Setting Facility Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,290.87 | Facility | None | $2,187.76 | $2,187.76 | $2,290.87 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $1,659.59 Typical High $4,265.80 | Professional | None | $1,288.25 | $1,659.59 | $4,265.80 |
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 $691.83 Median $741.31 Typical High $1,096.48 | Professional | 52 · Reduced service | $691.83 | $741.31 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $295.12 Typical High $436.52 | Professional | 53 · Discontinued | $275.42 | $295.12 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $223.87 Typical High $331.13 | Professional | 55 · Aftercare only | $208.93 | $223.87 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $147.91 Typical High $218.78 | Professional | 56 · Pre-op care only | $138.04 | $147.91 | $218.78 |
Where Georgia sits
The same service costs 3.2 times more in Hawaii than in Washington, DC. 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
$2,754
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.