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 $851.14 Median $851.14 Typical High $1,348.96 | Facility | None | $851.14 | $851.14 | $1,348.96 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $912.01 Typical High $1,318.26 | Professional | None | $851.14 | $912.01 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,089.30 Median $7,244.36 Typical High $7,585.78 | Facility | None | $2,089.30 | $7,244.36 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,819.70 Typical High $6,760.83 | Professional | None | $1,122.02 | $1,819.70 | $6,760.83 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $123.03 Median $275.42 Typical High $1,258.93 | Professional | RR · Rental | $123.03 | $275.42 | $1,258.93 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $933.25 Median $2,089.30 Typical High $9,549.93 | Professional | UE · Used equipment | $933.25 | $2,089.30 | $9,549.93 |
CareSource Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,737.80 | $1,737.80 | $1,737.80 |
CareSource Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Facility | None | $1,258.93 | $1,258.93 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $2,754.23 | Professional | None | $933.25 | $933.25 | $2,754.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,445.44 Median $2,089.30 Typical High $2,951.21 | Professional | None | $1,445.44 | $2,089.30 | $2,951.21 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,584.89 | Facility | None | $1,348.96 | $1,348.96 | $1,584.89 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,023.29 Typical High $2,630.27 | Professional | None | $794.33 | $1,023.29 | $2,630.27 |
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 $426.58 Median $457.09 Typical High $660.69 | Professional | 52 · Reduced service | $426.58 | $457.09 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $181.97 Typical High $269.15 | Professional | 53 · Discontinued | $169.82 | $181.97 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $138.04 Typical High $199.53 | Professional | 55 · Aftercare only | $125.89 | $138.04 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $91.20 Typical High $131.83 | Professional | 56 · Pre-op care only | $85.11 | $91.20 | $131.83 |
Where Georgia sits
The same service costs 3.8 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· 16th of 51
$1,698
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.