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 $812.83 Median $812.83 Typical High $1,288.25 | Facility | None | $812.83 | $812.83 | $1,288.25 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $870.96 Typical High $1,230.27 | Professional | None | $812.83 | $870.96 | $1,230.27 |
Ambetter Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,884.03 | $2,884.03 | $2,884.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,995.26 Median $6,760.83 Typical High $7,244.36 | Facility | None | $1,995.26 | $6,760.83 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,621.81 Typical High $5,623.41 | Professional | None | $1,071.52 | $1,621.81 | $5,623.41 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $117.49 Median $263.03 Typical High $1,202.26 | Professional | RR · Rental | $117.49 | $263.03 | $1,202.26 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $870.96 Median $1,995.26 Typical High $8,912.51 | Professional | UE · Used equipment | $870.96 | $1,995.26 | $8,912.51 |
CareSource Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,659.59 | $1,659.59 | $1,659.59 |
CareSource Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,659.59 | $1,659.59 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,230.27 | $1,230.27 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $2,630.27 | Professional | None | $891.25 | $891.25 | $2,630.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,380.38 Median $1,995.26 Typical High $2,818.38 | Professional | None | $1,380.38 | $1,995.26 | $2,818.38 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,202.26 | Facility | None | $1,071.52 | $1,071.52 | $1,202.26 |
United Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $2,454.71 | Professional | None | $758.58 | $954.99 | $2,454.71 |
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 $407.38 Median $436.52 Typical High $616.60 | Professional | 52 · Reduced service | $407.38 | $436.52 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $173.78 Typical High $245.47 | Professional | 53 · Discontinued | $162.18 | $173.78 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $128.82 Typical High $181.97 | Professional | 55 · Aftercare only | $120.23 | $128.82 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $87.10 Typical High $123.03 | Professional | 56 · Pre-op care only | $81.28 | $87.10 | $123.03 |
Where Georgia sits
The same service costs 3.1 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· 20th of 51
$1,445
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.