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 $1,380.38 | Facility | None | $851.14 | $851.14 | $1,380.38 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $891.25 Typical High $1,288.25 | Professional | None | $851.14 | $891.25 | $1,288.25 |
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 $112.20 Median $245.47 Typical High $1,122.02 | Professional | RR · Rental | $112.20 | $245.47 | $1,122.02 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $831.76 Median $1,862.09 Typical High $8,511.38 | Professional | UE · Used equipment | $831.76 | $1,862.09 | $8,511.38 |
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 $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $2,818.38 | Professional | None | $954.99 | $954.99 | $2,818.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,479.11 Median $2,089.30 Typical High $2,951.21 | Professional | None | $1,479.11 | $2,089.30 | $2,951.21 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Facility | None | $1,000.00 | $1,000.00 | $1,000.00 |
United Setting Professional Modifier None Typical Low $707.95 Median $1,023.29 Typical High $2,630.27 | Professional | None | $707.95 | $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 $446.68 Typical High $645.65 | Professional | 52 · Reduced service | $426.58 | $446.68 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $177.83 Typical High $257.04 | Professional | 53 · Discontinued | $169.82 | $177.83 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $134.90 Typical High $194.98 | Professional | 55 · Aftercare only | $128.82 | $134.90 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $89.13 Typical High $128.82 | Professional | 56 · Pre-op care only | $85.11 | $89.13 | $128.82 |
Where Georgia sits
The same service costs 3.0 times more in Kansas 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· 14th 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.