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 $223.87 Median $223.87 Typical High $354.81 | Facility | None | $223.87 | $223.87 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $229.09 Typical High $338.84 | Professional | None | $223.87 | $229.09 | $338.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $549.54 Median $1,905.46 Typical High $1,995.26 | Facility | None | $549.54 | $1,905.46 | $1,995.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $478.63 Typical High $2,511.89 | Professional | None | $302.00 | $478.63 | $2,511.89 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $32.36 Median $54.95 Typical High $251.19 | Professional | RR · Rental | $32.36 | $54.95 | $251.19 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $239.88 Median $407.38 Typical High $1,862.09 | Professional | UE · Used equipment | $239.88 | $407.38 | $1,862.09 |
CareSource Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
CareSource Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $741.31 | Professional | None | $190.55 | $190.55 | $741.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $380.19 Median $549.54 Typical High $776.25 | Professional | None | $380.19 | $549.54 | $776.25 |
United Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
United Setting Professional Modifier None Typical Low $177.83 Median $269.15 Typical High $691.83 | Professional | None | $177.83 | $269.15 | $691.83 |
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 $112.20 Median $114.82 Typical High $169.82 | Professional | 52 · Reduced service | $112.20 | $114.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $45.71 Typical High $67.61 | Professional | 53 · Discontinued | $44.67 | $45.71 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $51.29 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.91 Typical High $33.88 | Professional | 56 · Pre-op care only | $22.39 | $22.91 | $33.88 |
Where Georgia sits
The same service costs 3.0 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· 11th of 51
$447
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.