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 $758.58 Median $758.58 Typical High $1,230.27 | Facility | None | $758.58 | $758.58 | $1,230.27 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $831.76 Typical High $1,174.90 | Professional | None | $758.58 | $831.76 | $1,174.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $6,456.54 Typical High $6,918.31 | Facility | None | $1,862.09 | $6,456.54 | $6,918.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,513.56 Typical High $5,248.07 | Professional | None | $1,023.29 | $1,513.56 | $5,248.07 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $112.20 Median $251.19 Typical High $1,148.15 | Professional | RR · Rental | $112.20 | $251.19 | $1,148.15 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $851.14 Median $1,862.09 Typical High $8,511.38 | Professional | UE · Used equipment | $851.14 | $1,862.09 | $8,511.38 |
CareSource Setting Facility Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,548.82 | $1,548.82 | $1,548.82 |
CareSource Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,412.54 | $1,412.54 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $2,511.89 | Professional | None | $1,023.29 | $1,023.29 | $2,511.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,318.26 Median $1,862.09 Typical High $2,630.27 | Professional | None | $1,318.26 | $1,862.09 | $2,630.27 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,318.26 | Facility | None | $1,230.27 | $1,230.27 | $1,318.26 |
United Setting Professional Modifier None Typical Low $724.44 Median $912.01 Typical High $2,344.23 | Professional | None | $724.44 | $912.01 | $2,344.23 |
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 $380.19 Median $407.38 Typical High $588.84 | Professional | 52 · Reduced service | $380.19 | $407.38 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $165.96 Typical High $234.42 | Professional | 53 · Discontinued | $154.88 | $165.96 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $123.03 Typical High $173.78 | Professional | 55 · Aftercare only | $114.82 | $123.03 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $83.18 Typical High $117.49 | Professional | 56 · Pre-op care only | $75.86 | $83.18 | $117.49 |
Where Georgia sits
The same service costs 3.6 times more in Hawaii than in Washington, DC. 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· 19th of 51
$1,413
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.