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 $4,265.80 Median $4,265.80 Typical High $6,918.31 | Facility | None | $4,265.80 | $4,265.80 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $4,265.80 Median $4,570.88 Typical High $6,606.93 | Professional | None | $4,265.80 | $4,570.88 | $6,606.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,471.29 Median $36,307.81 Typical High $38,904.51 | Facility | None | $10,471.29 | $36,307.81 | $38,904.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $5,623.41 Median $9,120.11 Typical High $33,884.42 | Professional | None | $5,623.41 | $9,120.11 | $33,884.42 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $562.34 Median $1,258.93 Typical High $5,754.40 | Professional | RR · Rental | $562.34 | $1,258.93 | $5,754.40 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4,265.80 Median $9,332.54 Typical High $42,657.95 | Professional | UE · Used equipment | $4,265.80 | $9,332.54 | $42,657.95 |
CareSource Setting Facility Modifier None Typical Low $8,709.64 Median $8,709.64 Typical High $8,709.64 | Facility | None | $8,709.64 | $8,709.64 | $8,709.64 |
CareSource Setting Professional Modifier None Typical Low $8,709.64 Median $8,709.64 Typical High $8,709.64 | Professional | None | $8,709.64 | $8,709.64 | $8,709.64 |
Cigna Setting Facility Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $6,606.93 | Facility | None | $6,606.93 | $6,606.93 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $14,125.38 | Professional | None | $4,897.79 | $4,897.79 | $14,125.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $7,413.10 Median $10,471.29 Typical High $16,595.87 | Professional | None | $7,413.10 | $10,471.29 | $16,595.87 |
United Setting Professional Modifier None Typical Low $3,630.78 Median $5,128.61 Typical High $13,182.57 | Professional | None | $3,630.78 | $5,128.61 | $13,182.57 |
2 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 55 · Aftercare only Typical Low $645.65 Median $676.08 Typical High $977.24 | Professional | 55 · Aftercare only | $645.65 | $676.08 | $977.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $426.58 Median $457.09 Typical High $660.69 | Professional | 56 · Pre-op care only | $426.58 | $457.09 | $660.69 |
Where Georgia sits
The same service costs 2.3 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
$8,511
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.