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 $1,445.44 Median $1,445.44 Typical High $2,344.23 | Facility | None | $1,445.44 | $1,445.44 | $2,344.23 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,513.56 Typical High $2,187.76 | Professional | None | $1,445.44 | $1,513.56 | $2,187.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,548.13 Median $12,302.69 Typical High $13,182.57 | Facility | None | $3,548.13 | $12,302.69 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,862.09 Median $3,090.30 Typical High $11,481.54 | Professional | None | $1,862.09 | $3,090.30 | $11,481.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $186.21 Median $416.87 Typical High $1,905.46 | Professional | RR · Rental | $186.21 | $416.87 | $1,905.46 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,412.54 Median $3,162.28 Typical High $14,125.38 | Professional | UE · Used equipment | $1,412.54 | $3,162.28 | $14,125.38 |
CareSource Setting Facility Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Facility | None | $2,951.21 | $2,951.21 | $2,951.21 |
CareSource Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,951.21 | $2,951.21 | $2,951.21 |
Cigna Setting Facility Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Facility | None | $2,570.40 | $2,570.40 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $4,786.30 | Professional | None | $1,862.09 | $1,862.09 | $4,786.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,511.89 Median $3,548.13 Typical High $5,011.87 | Professional | None | $2,511.89 | $3,548.13 | $5,011.87 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,659.59 | Facility | None | $1,288.25 | $1,288.25 | $1,659.59 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,737.80 Typical High $4,466.84 | Professional | None | $1,202.26 | $1,737.80 | $4,466.84 |
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 $724.44 Median $758.58 Typical High $1,096.48 | Professional | 52 · Reduced service | $724.44 | $758.58 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $302.00 Typical High $436.52 | Professional | 53 · Discontinued | $288.40 | $302.00 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $223.87 Typical High $331.13 | Professional | 55 · Aftercare only | $218.78 | $223.87 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $151.36 Typical High $218.78 | Professional | 56 · Pre-op care only | $144.54 | $151.36 | $218.78 |
Where Georgia sits
The same service costs 2.4 times more in Wisconsin than in Washington, DC. 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
$2,884
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.