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 $912.01 Median $912.01 Typical High $1,445.44 | Facility | None | $912.01 | $912.01 | $1,445.44 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $977.24 Typical High $1,412.54 | Professional | None | $912.01 | $977.24 | $1,412.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,238.72 Median $7,585.78 Typical High $8,128.31 | Facility | None | $2,238.72 | $7,585.78 | $8,128.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,819.70 Typical High $6,309.57 | Professional | None | $1,202.26 | $1,819.70 | $6,309.57 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $131.83 Median $295.12 Typical High $1,348.96 | Professional | RR · Rental | $131.83 | $295.12 | $1,348.96 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $977.24 Median $2,238.72 Typical High $10,000.00 | Professional | UE · Used equipment | $977.24 | $2,238.72 | $10,000.00 |
CareSource Setting Facility Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Facility | None | $1,862.09 | $1,862.09 | $1,862.09 |
CareSource Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Facility | None | $1,584.89 | $1,584.89 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $2,951.21 | Professional | None | $1,174.90 | $1,174.90 | $2,951.21 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,548.82 Median $2,238.72 Typical High $3,162.28 | Professional | None | $1,548.82 | $2,238.72 | $3,162.28 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,445.44 | Facility | None | $1,258.93 | $1,258.93 | $1,445.44 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,071.52 Typical High $2,754.23 | Professional | None | $851.14 | $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 $457.09 Median $489.78 Typical High $707.95 | Professional | 52 · Reduced service | $457.09 | $489.78 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $194.98 Typical High $281.84 | Professional | 53 · Discontinued | $181.97 | $194.98 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $144.54 Typical High $213.80 | Professional | 55 · Aftercare only | $134.90 | $144.54 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $97.72 Typical High $141.25 | Professional | 56 · Pre-op care only | $91.20 | $97.72 | $141.25 |
Where Georgia sits
The same service costs 2.7 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· 21st of 51
$1,622
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.