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 $323.59 Median $323.59 Typical High $512.86 | Facility | None | $323.59 | $323.59 | $512.86 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $331.13 Typical High $489.78 | Professional | None | $323.59 | $331.13 | $489.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $2,754.23 Typical High $2,884.03 | Facility | None | $794.33 | $2,754.23 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $426.58 Median $645.65 Typical High $2,238.72 | Professional | None | $426.58 | $645.65 | $2,238.72 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $45.71 Median $85.11 Typical High $389.05 | Professional | RR · Rental | $45.71 | $85.11 | $389.05 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $346.74 Median $630.96 Typical High $2,884.03 | Professional | UE · Used equipment | $346.74 | $630.96 | $2,884.03 |
CareSource Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Facility | None | $660.69 | $660.69 | $660.69 |
CareSource Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $1,047.13 | Professional | None | $281.84 | $281.84 | $1,047.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $549.54 Median $794.33 Typical High $1,122.02 | Professional | None | $549.54 | $794.33 | $1,122.02 |
United Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $331.13 | Facility | None | $281.84 | $281.84 | $331.13 |
United Setting Professional Modifier None Typical Low $257.04 Median $389.05 Typical High $977.24 | Professional | None | $257.04 | $389.05 | $977.24 |
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 $162.18 Median $165.96 Typical High $245.47 | Professional | 52 · Reduced service | $162.18 | $165.96 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $66.07 Typical High $97.72 | Professional | 53 · Discontinued | $64.57 | $66.07 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $48.98 Typical High $74.13 | Professional | 55 · Aftercare only | $47.86 | $48.98 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $33.11 Typical High $48.98 | Professional | 56 · Pre-op care only | $32.36 | $33.11 | $48.98 |
Where Georgia sits
The same service costs 2.6 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
$562
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.