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 $645.65 Median $645.65 Typical High $1,023.29 | Facility | None | $645.65 | $645.65 | $1,023.29 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $691.83 Typical High $977.24 | Professional | None | $645.65 | $691.83 | $977.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,584.89 Median $5,495.41 Typical High $5,754.40 | Facility | None | $1,584.89 | $5,495.41 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,380.38 Typical High $9,549.93 | Professional | None | $870.96 | $1,380.38 | $9,549.93 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $123.03 Median $208.93 Typical High $954.99 | Professional | RR · Rental | $123.03 | $208.93 | $954.99 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $933.25 Median $1,584.89 Typical High $7,244.36 | Professional | UE · Used equipment | $933.25 | $1,584.89 | $7,244.36 |
CareSource Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
CareSource Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Facility | None | $954.99 | $954.99 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $2,089.30 | Professional | None | $707.95 | $707.95 | $2,089.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,096.48 Median $1,584.89 Typical High $2,238.72 | Professional | None | $1,096.48 | $1,584.89 | $2,238.72 |
United Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $1,023.29 | Facility | None | $173.78 | $173.78 | $1,023.29 |
United Setting Professional Modifier None Typical Low $602.56 Median $776.25 Typical High $1,949.84 | Professional | None | $602.56 | $776.25 | $1,949.84 |
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 $323.59 Median $346.74 Typical High $489.78 | Professional | 52 · Reduced service | $323.59 | $346.74 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $138.04 Typical High $199.53 | Professional | 53 · Discontinued | $128.82 | $138.04 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $102.33 Typical High $147.91 | Professional | 55 · Aftercare only | $95.50 | $102.33 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $69.18 Typical High $97.72 | Professional | 56 · Pre-op care only | $64.57 | $69.18 | $97.72 |
Where Georgia sits
The same service costs 3.2 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· 15th of 51
$1,380
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.