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 $2,187.76 Median $2,187.76 Typical High $3,467.37 | Facility | None | $2,187.76 | $2,187.76 | $3,467.37 |
Aetna Setting Professional Modifier None Typical Low $2,187.76 Median $2,344.23 Typical High $3,311.31 | Professional | None | $2,187.76 | $2,344.23 | $3,311.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,370.32 Median $18,620.87 Typical High $19,498.45 | Facility | None | $5,370.32 | $18,620.87 | $19,498.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,884.03 Median $4,677.35 Typical High $17,378.01 | Professional | None | $2,884.03 | $4,677.35 | $17,378.01 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $316.23 Median $707.95 Typical High $3,235.94 | Professional | RR · Rental | $316.23 | $707.95 | $3,235.94 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2,398.83 Median $5,370.32 Typical High $23,988.33 | Professional | UE · Used equipment | $2,398.83 | $5,370.32 | $23,988.33 |
CareSource Setting Facility Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $4,466.84 | Facility | None | $4,466.84 | $4,466.84 | $4,466.84 |
CareSource Setting Professional Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $4,466.84 | Professional | None | $4,466.84 | $4,466.84 | $4,466.84 |
Cigna Setting Facility Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Facility | None | $3,715.35 | $3,715.35 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $7,079.46 | Professional | None | $2,754.23 | $2,754.23 | $7,079.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,715.35 Median $5,370.32 Typical High $7,585.78 | Professional | None | $3,715.35 | $5,370.32 | $7,585.78 |
United Setting Facility Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Facility | None | $3,467.37 | $3,467.37 | $3,467.37 |
United Setting Professional Modifier None Typical Low $2,041.74 Median $2,630.27 Typical High $6,760.83 | Professional | None | $2,041.74 | $2,630.27 | $6,760.83 |
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 $1,096.48 Median $1,174.90 Typical High $1,659.59 | Professional | 52 · Reduced service | $1,096.48 | $1,174.90 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $467.74 Typical High $660.69 | Professional | 53 · Discontinued | $436.52 | $467.74 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $346.74 Typical High $501.19 | Professional | 55 · Aftercare only | $323.59 | $346.74 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $234.42 Typical High $331.13 | Professional | 56 · Pre-op care only | $218.78 | $234.42 | $331.13 |
Where Georgia sits
The same service costs 2.9 times more in Hawaii 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· 17th of 51
$4,365
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.