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 $331.13 Median $331.13 Typical High $524.81 | Facility | None | $331.13 | $331.13 | $524.81 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $354.81 Typical High $501.19 | Professional | None | $331.13 | $354.81 | $501.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $812.83 Median $2,818.38 Typical High $2,951.21 | Facility | None | $812.83 | $2,818.38 | $2,951.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $436.52 Median $707.95 Typical High $3,019.95 | Professional | None | $436.52 | $707.95 | $3,019.95 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $47.86 Median $107.15 Typical High $489.78 | Professional | RR · Rental | $47.86 | $107.15 | $489.78 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $363.08 Median $812.83 Typical High $3,715.35 | Professional | UE · Used equipment | $363.08 | $812.83 | $3,715.35 |
CareSource Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
CareSource Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Facility | None | $588.84 | $588.84 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $1,071.52 | Professional | None | $426.58 | $426.58 | $1,071.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $562.34 Median $812.83 Typical High $1,148.15 | Professional | None | $562.34 | $812.83 | $1,148.15 |
United Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $398.11 | Facility | None | $181.97 | $181.97 | $398.11 |
United Setting Professional Modifier None Typical Low $309.03 Median $398.11 Typical High $1,000.00 | Professional | None | $309.03 | $398.11 | $1,000.00 |
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 $165.96 Median $177.83 Typical High $251.19 | Professional | 52 · Reduced service | $165.96 | $177.83 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $70.79 Typical High $100.00 | Professional | 53 · Discontinued | $66.07 | $70.79 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $52.48 Typical High $75.86 | Professional | 55 · Aftercare only | $48.98 | $52.48 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $35.48 Typical High $50.12 | Professional | 56 · Pre-op care only | $33.11 | $35.48 | $50.12 |
Where Georgia sits
The same service costs 2.5 times more in Montana than in Alabama. 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· 11th of 51
$661
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.