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 $1,949.84 Median $1,949.84 Typical High $3,162.28 | Facility | None | $1,949.84 | $1,949.84 | $3,162.28 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $2,041.74 Typical High $3,019.95 | Professional | None | $1,949.84 | $2,041.74 | $3,019.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $16,595.87 Typical High $17,782.79 | Facility | None | $4,786.30 | $16,595.87 | $17,782.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,019.95 Median $4,168.69 Typical High $13,803.84 | Professional | None | $3,019.95 | $4,168.69 | $13,803.84 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $302.00 Median $478.63 Typical High $2,454.71 | Professional | RR · Rental | $302.00 | $478.63 | $2,454.71 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2,290.87 Median $3,630.78 Typical High $18,620.87 | Professional | UE · Used equipment | $2,290.87 | $3,630.78 | $18,620.87 |
CareSource Setting Facility Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Facility | None | $3,981.07 | $3,981.07 | $3,981.07 |
CareSource Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Professional | None | $3,981.07 | $3,981.07 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Facility | None | $3,019.95 | $3,019.95 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $6,456.54 | Professional | None | $2,187.76 | $2,187.76 | $6,456.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,388.44 Median $4,786.30 Typical High $9,332.54 | Professional | None | $3,388.44 | $4,786.30 | $9,332.54 |
United Setting Professional Modifier None Typical Low $1,584.89 Median $2,344.23 Typical High $6,025.60 | Professional | None | $1,584.89 | $2,344.23 | $6,025.60 |
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 $977.24 Median $1,023.29 Typical High $1,479.11 | Professional | 52 · Reduced service | $977.24 | $1,023.29 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $407.38 Typical High $602.56 | Professional | 53 · Discontinued | $398.11 | $407.38 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $309.03 Typical High $446.68 | Professional | 55 · Aftercare only | $295.12 | $309.03 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $204.17 Typical High $302.00 | Professional | 56 · Pre-op care only | $194.98 | $204.17 | $302.00 |
Where Georgia sits
The same service costs 2.4 times more in Hawaii than in West Virginia. 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· 13th of 51
$4,169
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.