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 $1,288.25 Typical High $1,819.70 | Professional | None | $1,202.26 | $1,288.25 | $1,819.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $10,000.00 Typical High $10,715.19 | Facility | None | $2,884.03 | $10,000.00 | $10,715.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,584.89 Median $2,511.89 Typical High $9,332.54 | Professional | None | $1,584.89 | $2,511.89 | $9,332.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $169.82 Median $389.05 Typical High $1,778.28 | Professional | RR · Rental | $169.82 | $389.05 | $1,778.28 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,288.25 Median $2,884.03 Typical High $13,182.57 | Professional | UE · Used equipment | $1,288.25 | $2,884.03 | $13,182.57 |
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 $2,041.74 Median $2,041.74 Typical High $2,041.74 | Facility | None | $2,041.74 | $2,041.74 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $3,890.45 | Professional | None | $1,513.56 | $1,513.56 | $3,890.45 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,041.74 Median $2,884.03 Typical High $4,168.69 | Professional | None | $2,041.74 | $2,884.03 | $4,168.69 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,949.84 | Facility | None | $1,905.46 | $1,905.46 | $1,949.84 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,412.54 Typical High $3,630.78 | Professional | None | $1,122.02 | $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 $588.84 Median $645.65 Typical High $912.01 | Professional | 52 · Reduced service | $588.84 | $645.65 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $257.04 Typical High $363.08 | Professional | 53 · Discontinued | $239.88 | $257.04 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $190.55 Typical High $269.15 | Professional | 55 · Aftercare only | $177.83 | $190.55 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $128.82 Typical High $181.97 | Professional | 56 · Pre-op care only | $120.23 | $128.82 | $181.97 |
Where Georgia sits
The same service costs 3.1 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· 16th of 51
$2,344
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.