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 $2,570.40 Median $2,570.40 Typical High $4,168.69 | Facility | None | $2,570.40 | $2,570.40 | $4,168.69 |
Aetna Setting Professional Modifier None Typical Low $2,570.40 Median $2,754.23 Typical High $4,168.69 | Professional | None | $2,570.40 | $2,754.23 | $4,168.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,309.57 Median $21,877.62 Typical High $23,442.29 | Facility | None | $6,309.57 | $21,877.62 | $23,442.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,467.37 Median $5,495.41 Typical High $20,417.38 | Professional | None | $3,467.37 | $5,495.41 | $20,417.38 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $380.19 Median $831.76 Typical High $3,801.89 | Professional | RR · Rental | $380.19 | $831.76 | $3,801.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2,818.38 Median $6,309.57 Typical High $28,840.32 | Professional | UE · Used equipment | $2,818.38 | $6,309.57 | $28,840.32 |
CareSource Setting Facility Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $5,248.07 | Facility | None | $5,248.07 | $5,248.07 | $5,248.07 |
CareSource Setting Professional Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $5,248.07 | Professional | None | $5,248.07 | $5,248.07 | $5,248.07 |
Cigna Setting Facility Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $4,897.79 | Facility | None | $4,897.79 | $4,897.79 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $8,511.38 | Professional | None | $3,548.13 | $3,548.13 | $8,511.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4,466.84 Median $6,309.57 Typical High $8,912.51 | Professional | None | $4,466.84 | $6,309.57 | $8,912.51 |
United Setting Facility Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $5,370.32 | Facility | None | $4,073.80 | $4,073.80 | $5,370.32 |
United Setting Professional Modifier None Typical Low $2,398.83 Median $3,090.30 Typical High $7,943.28 | Professional | None | $2,398.83 | $3,090.30 | $7,943.28 |
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 $1,288.25 Median $1,380.38 Typical High $2,089.30 | Professional | 52 · Reduced service | $1,288.25 | $1,380.38 | $2,089.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $549.54 Typical High $831.76 | Professional | 53 · Discontinued | $512.86 | $549.54 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $416.87 Typical High $616.60 | Professional | 55 · Aftercare only | $389.05 | $416.87 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $275.42 Typical High $416.87 | Professional | 56 · Pre-op care only | $257.04 | $275.42 | $416.87 |
Where Georgia sits
The same service costs 3.5 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· 17th of 51
$5,129
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.