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 $1,737.80 Median $1,737.80 Typical High $2,818.38 | Facility | None | $1,737.80 | $1,737.80 | $2,818.38 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,905.46 Typical High $2,691.53 | Professional | None | $1,737.80 | $1,905.46 | $2,691.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,265.80 Median $14,791.08 Typical High $15,848.93 | Facility | None | $4,265.80 | $14,791.08 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,344.23 Median $3,467.37 Typical High $12,022.64 | Professional | None | $2,344.23 | $3,467.37 | $12,022.64 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $251.19 Median $549.54 Typical High $2,511.89 | Professional | RR · Rental | $251.19 | $549.54 | $2,511.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,905.46 Median $4,168.69 Typical High $19,054.61 | Professional | UE · Used equipment | $1,905.46 | $4,168.69 | $19,054.61 |
CareSource Setting Facility Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Facility | None | $3,548.13 | $3,548.13 | $3,548.13 |
CareSource Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Professional | None | $3,548.13 | $3,548.13 | $3,548.13 |
Cigna Setting Facility Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Facility | None | $3,388.44 | $3,388.44 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $5,754.40 | Professional | None | $2,454.71 | $2,454.71 | $5,754.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,019.95 Median $4,265.80 Typical High $6,025.60 | Professional | None | $3,019.95 | $4,265.80 | $6,025.60 |
United Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Facility | None | $2,398.83 | $2,398.83 | $2,398.83 |
United Setting Professional Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $5,370.32 | Professional | None | $1,584.89 | $2,089.30 | $5,370.32 |
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 $870.96 Median $933.25 Typical High $1,348.96 | Professional | 52 · Reduced service | $870.96 | $933.25 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $380.19 Typical High $537.03 | Professional | 53 · Discontinued | $354.81 | $380.19 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $281.84 Typical High $398.11 | Professional | 55 · Aftercare only | $263.03 | $281.84 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $190.55 Typical High $269.15 | Professional | 56 · Pre-op care only | $173.78 | $190.55 | $269.15 |
Where Georgia sits
The same service costs 2.1 times more in Montana than in South Carolina. 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· 18th of 51
$3,388
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.