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 $2,137.96 Median $2,137.96 Typical High $3,388.44 | Facility | None | $2,137.96 | $2,137.96 | $3,388.44 |
Aetna Setting Professional Modifier None Typical Low $2,137.96 Median $2,290.87 Typical High $3,235.94 | Professional | None | $2,137.96 | $2,290.87 | $3,235.94 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,248.07 Median $18,197.01 Typical High $19,054.61 | Facility | None | $5,248.07 | $18,197.01 | $19,054.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,818.38 Median $4,466.84 Typical High $16,982.44 | Professional | None | $2,818.38 | $4,466.84 | $16,982.44 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $295.12 Median $660.69 Typical High $3,019.95 | Professional | RR · Rental | $295.12 | $660.69 | $3,019.95 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2,238.72 Median $4,897.79 Typical High $22,387.21 | Professional | UE · Used equipment | $2,238.72 | $4,897.79 | $22,387.21 |
CareSource Setting Facility Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $4,365.16 | Facility | None | $4,365.16 | $4,365.16 | $4,365.16 |
CareSource Setting Professional Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $4,365.16 | Professional | None | $4,365.16 | $4,365.16 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Facility | None | $3,548.13 | $3,548.13 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $6,918.31 | Professional | None | $2,630.27 | $2,630.27 | $6,918.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,630.78 Median $5,248.07 Typical High $7,413.10 | Professional | None | $3,630.78 | $5,248.07 | $7,413.10 |
United Setting Facility Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $4,365.16 | Facility | None | $3,235.94 | $3,235.94 | $4,365.16 |
United Setting Professional Modifier None Typical Low $1,905.46 Median $2,570.40 Typical High $6,456.54 | Professional | None | $1,905.46 | $2,570.40 | $6,456.54 |
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 $1,071.52 Median $1,148.15 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,071.52 | $1,148.15 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $457.09 Typical High $645.65 | Professional | 53 · Discontinued | $426.58 | $457.09 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $338.84 Typical High $478.63 | Professional | 55 · Aftercare only | $316.23 | $338.84 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $229.09 Typical High $323.59 | Professional | 56 · Pre-op care only | $213.80 | $229.09 | $323.59 |
Where Georgia sits
The same service costs 4.3 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· 14th of 51
$4,266
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.