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 $245.47 Median $245.47 Typical High $398.11 | Facility | None | $245.47 | $245.47 | $398.11 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $263.03 Typical High $380.19 | Professional | None | $245.47 | $263.03 | $380.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $602.56 Median $2,089.30 Typical High $2,238.72 | Facility | None | $602.56 | $2,089.30 | $2,238.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $524.81 Typical High $3,630.78 | Professional | None | $331.13 | $524.81 | $3,630.78 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $36.31 Median $81.28 Typical High $363.08 | Professional | RR · Rental | $36.31 | $81.28 | $363.08 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $269.15 Median $602.56 Typical High $2,754.23 | Professional | UE · Used equipment | $269.15 | $602.56 | $2,754.23 |
CareSource Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
CareSource Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $812.83 | Professional | None | $295.12 | $295.12 | $812.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $426.58 Median $602.56 Typical High $851.14 | Professional | None | $426.58 | $602.56 | $851.14 |
United Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
United Setting Professional Modifier None Typical Low $229.09 Median $295.12 Typical High $758.58 | Professional | None | $229.09 | $295.12 | $758.58 |
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 $123.03 Median $131.83 Typical High $190.55 | Professional | 52 · Reduced service | $123.03 | $131.83 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $52.48 Typical High $75.86 | Professional | 53 · Discontinued | $48.98 | $52.48 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $39.81 Typical High $57.54 | Professional | 55 · Aftercare only | $37.15 | $39.81 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $26.30 Typical High $38.02 | Professional | 56 · Pre-op care only | $24.55 | $26.30 | $38.02 |
Where Georgia sits
The same service costs 3.7 times more in Hawaii 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
$490
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.