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 $251.19 Median $251.19 Typical High $398.11 | Facility | None | $251.19 | $251.19 | $398.11 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $263.03 Typical High $398.11 | Professional | None | $251.19 | $263.03 | $398.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $616.60 Median $2,137.96 Typical High $2,238.72 | Facility | None | $616.60 | $2,137.96 | $2,238.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $338.84 Median $537.03 Typical High $1,995.26 | Professional | None | $338.84 | $537.03 | $1,995.26 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $35.48 Median $79.43 Typical High $363.08 | Professional | RR · Rental | $35.48 | $79.43 | $363.08 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $269.15 Median $602.56 Typical High $2,691.53 | Professional | UE · Used equipment | $269.15 | $602.56 | $2,691.53 |
CareSource Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
CareSource Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $831.76 | Professional | None | $371.54 | $371.54 | $831.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $426.58 Median $616.60 Typical High $870.96 | Professional | None | $426.58 | $616.60 | $870.96 |
United Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
United Setting Professional Modifier None Typical Low $229.09 Median $302.00 Typical High $776.25 | Professional | None | $229.09 | $302.00 | $776.25 |
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 $125.89 Median $131.83 Typical High $199.53 | Professional | 52 · Reduced service | $125.89 | $131.83 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $52.48 Typical High $81.28 | Professional | 53 · Discontinued | $50.12 | $52.48 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $39.81 Typical High $60.26 | Professional | 55 · Aftercare only | $38.02 | $39.81 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $26.30 Typical High $39.81 | Professional | 56 · Pre-op care only | $25.12 | $26.30 | $39.81 |
Where Georgia sits
The same service costs 3.0 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· 15th of 51
$501
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.