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 $223.87 Median $223.87 Typical High $363.08 | Facility | None | $223.87 | $223.87 | $363.08 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $239.88 Typical High $363.08 | Professional | None | $223.87 | $239.88 | $363.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $549.54 Median $1,905.46 Typical High $1,995.26 | Facility | None | $549.54 | $1,905.46 | $1,995.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $446.68 Typical High $1,548.82 | Professional | None | $302.00 | $446.68 | $1,548.82 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $32.36 Median $72.44 Typical High $331.13 | Professional | RR · Rental | $32.36 | $72.44 | $331.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $239.88 Median $549.54 Typical High $2,511.89 | Professional | UE · Used equipment | $239.88 | $549.54 | $2,511.89 |
CareSource Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
CareSource Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $741.31 | Professional | None | $288.40 | $288.40 | $741.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $389.05 Median $549.54 Typical High $776.25 | Professional | None | $389.05 | $549.54 | $776.25 |
United Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $331.13 | Facility | None | $281.84 | $281.84 | $331.13 |
United Setting Professional Modifier None Typical Low $208.93 Median $269.15 Typical High $691.83 | Professional | None | $208.93 | $269.15 | $691.83 |
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 $112.20 Median $120.23 Typical High $177.83 | Professional | 52 · Reduced service | $112.20 | $120.23 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $47.86 Typical High $72.44 | Professional | 53 · Discontinued | $44.67 | $47.86 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $36.31 Typical High $53.70 | Professional | 55 · Aftercare only | $33.88 | $36.31 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $23.99 Typical High $36.31 | Professional | 56 · Pre-op care only | $22.39 | $23.99 | $36.31 |
Where Georgia sits
The same service costs 2.6 times more in Hawaii 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· 20th of 51
$407
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.