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 $1,202.26 Median $1,202.26 Typical High $1,905.46 | Facility | None | $1,202.26 | $1,202.26 | $1,905.46 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $3,162.28 | Professional | None | $1,202.26 | $1,380.38 | $3,162.28 |
Ambetter Setting Professional Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $5,623.41 | Professional | None | $5,623.41 | $5,623.41 | $5,623.41 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,951.21 Median $10,000.00 Typical High $10,715.19 | Facility | None | $2,951.21 | $10,000.00 | $10,715.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,584.89 Median $2,511.89 Typical High $9,549.93 | Professional | None | $1,584.89 | $2,511.89 | $9,549.93 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $169.82 Median $309.03 Typical High $1,412.54 | Professional | RR · Rental | $169.82 | $309.03 | $1,412.54 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,288.25 Median $2,344.23 Typical High $10,715.19 | Professional | UE · Used equipment | $1,288.25 | $2,344.23 | $10,715.19 |
CareSource Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Facility | None | $2,454.71 | $2,454.71 | $2,454.71 |
CareSource Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $3,890.45 | Professional | None | $1,318.26 | $1,318.26 | $3,890.45 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,041.74 Median $2,951.21 Typical High $4,168.69 | Professional | None | $2,041.74 | $2,951.21 | $4,168.69 |
United Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $1,148.15 | Facility | None | $870.96 | $870.96 | $1,148.15 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,412.54 Typical High $3,630.78 | Professional | None | $954.99 | $1,412.54 | $3,630.78 |
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 $602.56 Median $616.60 Typical High $912.01 | Professional | 52 · Reduced service | $602.56 | $616.60 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $245.47 Typical High $363.08 | Professional | 53 · Discontinued | $239.88 | $245.47 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $186.21 Typical High $269.15 | Professional | 55 · Aftercare only | $177.83 | $186.21 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $123.03 Typical High $181.97 | Professional | 56 · Pre-op care only | $120.23 | $123.03 | $181.97 |
Where Georgia sits
The same service costs 2.3 times more in Wisconsin than in Pennsylvania. 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· 9th of 51
$2,399
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.