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 $602.56 Median $602.56 Typical High $954.99 | Facility | None | $602.56 | $602.56 | $954.99 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $645.65 Typical High $912.01 | Professional | None | $602.56 | $645.65 | $912.01 |
Ambetter Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,818.38 | $2,818.38 | $2,818.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $5,128.61 Typical High $5,370.32 | Facility | None | $1,479.11 | $5,128.61 | $5,370.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $812.83 Median $1,288.25 Typical High $5,495.41 | Professional | None | $812.83 | $1,288.25 | $5,495.41 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $87.10 Median $194.98 Typical High $891.25 | Professional | RR · Rental | $87.10 | $194.98 | $891.25 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $660.69 Median $1,479.11 Typical High $6,760.83 | Professional | UE · Used equipment | $660.69 | $1,479.11 | $6,760.83 |
CareSource Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,230.27 | $1,230.27 | $1,230.27 |
CareSource Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Facility | None | $1,202.26 | $1,202.26 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,949.84 | Professional | None | $870.96 | $870.96 | $1,949.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,023.29 Median $1,479.11 Typical High $2,089.30 | Professional | None | $1,023.29 | $1,479.11 | $2,089.30 |
United Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $724.44 | Facility | None | $457.09 | $457.09 | $724.44 |
United Setting Professional Modifier None Typical Low $562.34 Median $724.44 Typical High $1,862.09 | Professional | None | $562.34 | $724.44 | $1,862.09 |
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 $302.00 Median $323.59 Typical High $467.74 | Professional | 52 · Reduced service | $302.00 | $323.59 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $128.82 Typical High $186.21 | Professional | 53 · Discontinued | $120.23 | $128.82 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $97.72 Typical High $141.25 | Professional | 55 · Aftercare only | $89.13 | $97.72 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $64.57 Typical High $93.33 | Professional | 56 · Pre-op care only | $60.26 | $64.57 | $93.33 |
Where Georgia sits
The same service costs 2.6 times more in Montana than in Florida. 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· 17th of 51
$1,202
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.