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 $575.44 Median $575.44 Typical High $912.01 | Facility | None | $575.44 | $575.44 | $912.01 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $616.60 Typical High $870.96 | Professional | None | $575.44 | $616.60 | $870.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $4,897.79 Typical High $5,128.61 | Facility | None | $1,412.54 | $4,897.79 | $5,128.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $758.58 Median $1,230.27 Typical High $8,511.38 | Professional | None | $758.58 | $1,230.27 | $8,511.38 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $83.18 Median $186.21 Typical High $851.14 | Professional | RR · Rental | $83.18 | $186.21 | $851.14 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $630.96 Median $1,412.54 Typical High $6,456.54 | Professional | UE · Used equipment | $630.96 | $1,412.54 | $6,456.54 |
CareSource Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | None | $1,174.90 | $1,174.90 | $1,174.90 |
CareSource Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,174.90 | $1,174.90 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Facility | None | $1,047.13 | $1,047.13 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,862.09 | Professional | None | $758.58 | $758.58 | $1,862.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $977.24 Median $1,412.54 Typical High $1,995.26 | Professional | None | $977.24 | $1,412.54 | $1,995.26 |
United Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $1,000.00 | Facility | None | $912.01 | $912.01 | $1,000.00 |
United Setting Professional Modifier None Typical Low $537.03 Median $691.83 Typical High $1,778.28 | Professional | None | $537.03 | $691.83 | $1,778.28 |
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 $288.40 Median $309.03 Typical High $436.52 | Professional | 52 · Reduced service | $288.40 | $309.03 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $123.03 Typical High $173.78 | Professional | 53 · Discontinued | $114.82 | $123.03 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $91.20 Typical High $131.83 | Professional | 55 · Aftercare only | $85.11 | $91.20 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $61.66 Typical High $87.10 | Professional | 56 · Pre-op care only | $57.54 | $61.66 | $87.10 |
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
$1,148
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.