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 $1,862.09 Median $1,862.09 Typical High $3,019.95 | Facility | None | $1,862.09 | $1,862.09 | $3,019.95 |
Aetna Setting Professional Modifier None Typical Low $1,862.09 Median $1,949.84 Typical High $2,884.03 | Professional | None | $1,862.09 | $1,949.84 | $2,884.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,570.88 Median $15,848.93 Typical High $16,982.44 | Facility | None | $4,570.88 | $15,848.93 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,511.89 Median $3,981.07 Typical High $14,791.08 | Professional | None | $2,511.89 | $3,981.07 | $14,791.08 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $269.15 Median $549.54 Typical High $2,511.89 | Professional | RR · Rental | $269.15 | $549.54 | $2,511.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2,041.74 Median $4,073.80 Typical High $18,620.87 | Professional | UE · Used equipment | $2,041.74 | $4,073.80 | $18,620.87 |
CareSource Setting Facility Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $3,801.89 | Facility | None | $3,801.89 | $3,801.89 | $3,801.89 |
CareSource Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $3,801.89 | Professional | None | $3,801.89 | $3,801.89 | $3,801.89 |
Cigna Setting Facility Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Facility | None | $2,511.89 | $2,511.89 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $6,165.95 | Professional | None | $1,819.70 | $1,819.70 | $6,165.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,235.94 Median $4,570.88 Typical High $6,456.54 | Professional | None | $3,235.94 | $4,570.88 | $6,456.54 |
United Setting Facility Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Facility | None | $2,187.76 | $2,187.76 | $2,187.76 |
United Setting Professional Modifier None Typical Low $1,548.82 Median $2,238.72 Typical High $5,754.40 | Professional | None | $1,548.82 | $2,238.72 | $5,754.40 |
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 $933.25 Median $977.24 Typical High $1,412.54 | Professional | 52 · Reduced service | $933.25 | $977.24 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $398.11 Typical High $575.44 | Professional | 53 · Discontinued | $371.54 | $398.11 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $295.12 Typical High $426.58 | Professional | 55 · Aftercare only | $281.84 | $295.12 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $199.53 Typical High $288.40 | Professional | 56 · Pre-op care only | $186.21 | $199.53 | $288.40 |
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· 13th of 51
$3,715
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.