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 $891.25 Median $891.25 Typical High $1,412.54 | Facility | None | $891.25 | $891.25 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $954.99 Typical High $1,348.96 | Professional | None | $891.25 | $954.99 | $1,348.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,187.76 Median $7,585.78 Typical High $7,943.28 | Facility | None | $2,187.76 | $7,585.78 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,905.46 Typical High $7,079.46 | Professional | None | $1,202.26 | $1,905.46 | $7,079.46 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $128.82 Median $281.84 Typical High $1,288.25 | Professional | RR · Rental | $128.82 | $281.84 | $1,288.25 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $954.99 Median $2,137.96 Typical High $9,772.37 | Professional | UE · Used equipment | $954.99 | $2,137.96 | $9,772.37 |
CareSource Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
CareSource Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,621.81 | $1,621.81 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $2,884.03 | Professional | None | $1,174.90 | $1,174.90 | $2,884.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,513.56 Median $2,187.76 Typical High $3,090.30 | Professional | None | $1,513.56 | $2,187.76 | $3,090.30 |
United Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $1,380.38 | Facility | None | $776.25 | $776.25 | $1,380.38 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,071.52 Typical High $2,754.23 | Professional | None | $812.83 | $1,071.52 | $2,754.23 |
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 $446.68 Median $478.63 Typical High $676.08 | Professional | 52 · Reduced service | $446.68 | $478.63 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $190.55 Typical High $269.15 | Professional | 53 · Discontinued | $177.83 | $190.55 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $144.54 Typical High $204.17 | Professional | 55 · Aftercare only | $131.83 | $144.54 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $95.50 Typical High $134.90 | Professional | 56 · Pre-op care only | $89.13 | $95.50 | $134.90 |
Where Georgia sits
The same service costs 2.7 times more in Hawaii than in Pennsylvania. 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
$1,778
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.