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 $478.63 Median $478.63 Typical High $776.25 | Facility | None | $478.63 | $478.63 | $776.25 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $512.86 Typical High $741.31 | Professional | None | $478.63 | $512.86 | $741.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $4,073.80 Typical High $4,365.16 | Facility | None | $1,174.90 | $4,073.80 | $4,365.16 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $954.99 Typical High $3,311.31 | Professional | None | $645.65 | $954.99 | $3,311.31 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $69.18 Median $158.49 Typical High $724.44 | Professional | RR · Rental | $69.18 | $158.49 | $724.44 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $524.81 Median $1,174.90 Typical High $5,370.32 | Professional | UE · Used equipment | $524.81 | $1,174.90 | $5,370.32 |
CareSource Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Facility | None | $977.24 | $977.24 | $977.24 |
CareSource Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Facility | None | $933.25 | $933.25 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $1,584.89 | Professional | None | $676.08 | $676.08 | $1,584.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $831.76 Median $1,174.90 Typical High $1,659.59 | Professional | None | $831.76 | $1,174.90 | $1,659.59 |
United Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $575.44 | Facility | None | $478.63 | $478.63 | $575.44 |
United Setting Professional Modifier None Typical Low $457.09 Median $575.44 Typical High $1,479.11 | Professional | None | $457.09 | $575.44 | $1,479.11 |
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 $239.88 Median $257.04 Typical High $371.54 | Professional | 52 · Reduced service | $239.88 | $257.04 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $104.71 Typical High $147.91 | Professional | 53 · Discontinued | $95.50 | $104.71 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $77.62 Typical High $112.20 | Professional | 55 · Aftercare only | $72.44 | $77.62 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $51.29 Typical High $74.13 | Professional | 56 · Pre-op care only | $47.86 | $51.29 | $74.13 |
Where Georgia sits
The same service costs 2.1 times more in Wisconsin 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· 17th of 51
$912
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.