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 $363.08 Median $363.08 Typical High $588.84 | Facility | None | $363.08 | $363.08 | $588.84 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $389.05 Typical High $549.54 | Professional | None | $363.08 | $389.05 | $549.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $3,090.30 Typical High $3,311.31 | Facility | None | $891.25 | $3,090.30 | $3,311.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $724.44 Typical High $2,511.89 | Professional | None | $489.78 | $724.44 | $2,511.89 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $53.70 Median $120.23 Typical High $537.03 | Professional | RR · Rental | $53.70 | $120.23 | $537.03 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $398.11 Median $891.25 Typical High $4,073.80 | Professional | UE · Used equipment | $398.11 | $891.25 | $4,073.80 |
CareSource Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Facility | None | $741.31 | $741.31 | $741.31 |
CareSource Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | None | $741.31 | $741.31 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Facility | None | $616.60 | $616.60 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $1,202.26 | Professional | None | $446.68 | $446.68 | $1,202.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $891.25 Typical High $1,258.93 | Professional | None | $630.96 | $891.25 | $1,258.93 |
United Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $707.95 | Facility | None | $588.84 | $588.84 | $707.95 |
United Setting Professional Modifier None Typical Low $338.84 Median $436.52 Typical High $1,122.02 | Professional | None | $338.84 | $436.52 | $1,122.02 |
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 $181.97 Median $194.98 Typical High $275.42 | Professional | 52 · Reduced service | $181.97 | $194.98 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $77.62 Typical High $109.65 | Professional | 53 · Discontinued | $72.44 | $77.62 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $58.88 Typical High $83.18 | Professional | 55 · Aftercare only | $54.95 | $58.88 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $38.90 Typical High $54.95 | Professional | 56 · Pre-op care only | $36.31 | $38.90 | $54.95 |
Where Georgia sits
The same service costs 3.7 times more in Hawaii than in Tennessee. 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· 21st of 51
$661
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.