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 $288.40 Median $288.40 Typical High $457.09 | Facility | None | $288.40 | $288.40 | $457.09 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $302.00 Typical High $436.52 | Professional | None | $288.40 | $302.00 | $436.52 |
Ambetter Setting Professional Modifier None Typical Low $562.34 Median $1,348.96 Typical High $1,348.96 | Professional | None | $562.34 | $1,348.96 | $1,348.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $707.95 Median $2,454.71 Typical High $2,570.40 | Facility | None | $707.95 | $2,454.71 | $2,570.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $616.60 Typical High $2,290.87 | Professional | None | $389.05 | $616.60 | $2,290.87 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $41.69 Median $81.28 Typical High $371.54 | Professional | RR · Rental | $41.69 | $81.28 | $371.54 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $309.03 Median $602.56 Typical High $2,754.23 | Professional | UE · Used equipment | $309.03 | $602.56 | $2,754.23 |
CareSource Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Facility | None | $588.84 | $588.84 | $588.84 |
CareSource Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $933.25 | Professional | None | $275.42 | $275.42 | $933.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $489.78 Median $707.95 Typical High $1,000.00 | Professional | None | $489.78 | $707.95 | $1,000.00 |
United Setting Professional Modifier None Typical Low $234.42 Median $346.74 Typical High $891.25 | Professional | None | $234.42 | $346.74 | $891.25 |
2 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 55 · Aftercare only Typical Low $42.66 Median $44.67 Typical High $66.07 | Professional | 55 · Aftercare only | $42.66 | $44.67 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $29.51 Typical High $43.65 | Professional | 56 · Pre-op care only | $28.84 | $29.51 | $43.65 |
Where Georgia sits
The same service costs 3.7 times more in Alaska 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
$575
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.