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 $776.25 Median $776.25 Typical High $1,258.93 | Facility | None | $776.25 | $776.25 | $1,258.93 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $831.76 Typical High $1,258.93 | Professional | None | $776.25 | $831.76 | $1,258.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,905.46 Median $6,606.93 Typical High $6,918.31 | Facility | None | $1,905.46 | $6,606.93 | $6,918.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,659.59 Typical High $6,165.95 | Professional | None | $1,047.13 | $1,659.59 | $6,165.95 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $112.20 Median $251.19 Typical High $1,148.15 | Professional | RR · Rental | $112.20 | $251.19 | $1,148.15 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $851.14 Median $1,905.46 Typical High $8,709.64 | Professional | UE · Used equipment | $851.14 | $1,905.46 | $8,709.64 |
CareSource Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Facility | None | $1,584.89 | $1,584.89 | $1,584.89 |
CareSource Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | None | $1,174.90 | $1,174.90 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $2,570.40 | Professional | None | $851.14 | $851.14 | $2,570.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,348.96 Median $1,905.46 Typical High $2,691.53 | Professional | None | $1,348.96 | $1,905.46 | $2,691.53 |
United Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $933.25 | Facility | None | $741.31 | $741.31 | $933.25 |
United Setting Professional Modifier None Typical Low $724.44 Median $933.25 Typical High $2,398.83 | Professional | None | $724.44 | $933.25 | $2,398.83 |
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 $389.05 Median $416.87 Typical High $616.60 | Professional | 52 · Reduced service | $389.05 | $416.87 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $165.96 Typical High $251.19 | Professional | 53 · Discontinued | $154.88 | $165.96 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $125.89 Typical High $186.21 | Professional | 55 · Aftercare only | $117.49 | $125.89 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $83.18 Typical High $125.89 | Professional | 56 · Pre-op care only | $77.62 | $83.18 | $125.89 |
Where Georgia sits
The same service costs 3.0 times more in Montana 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· 16th of 51
$1,549
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.