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 $316.23 Median $316.23 Typical High $512.86 | Facility | None | $316.23 | $316.23 | $512.86 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $331.13 Typical High $478.63 | Professional | None | $316.23 | $331.13 | $478.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $776.25 Median $2,691.53 Typical High $2,818.38 | Facility | None | $776.25 | $2,691.53 | $2,818.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $436.52 Median $630.96 Typical High $2,187.76 | Professional | None | $436.52 | $630.96 | $2,187.76 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $45.71 Median $95.50 Typical High $436.52 | Professional | RR · Rental | $45.71 | $95.50 | $436.52 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $338.84 Median $724.44 Typical High $3,311.31 | Professional | UE · Used equipment | $338.84 | $724.44 | $3,311.31 |
CareSource Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Facility | None | $645.65 | $645.65 | $645.65 |
CareSource Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $1,047.13 | Professional | None | $331.13 | $331.13 | $1,047.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $549.54 Median $776.25 Typical High $1,096.48 | Professional | None | $549.54 | $776.25 | $1,096.48 |
United Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
United Setting Professional Modifier None Typical Low $275.42 Median $380.19 Typical High $977.24 | Professional | None | $275.42 | $380.19 | $977.24 |
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 $158.49 Median $165.96 Typical High $239.88 | Professional | 52 · Reduced service | $158.49 | $165.96 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $66.07 Typical High $95.50 | Professional | 53 · Discontinued | $63.10 | $66.07 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $50.12 Typical High $72.44 | Professional | 55 · Aftercare only | $47.86 | $50.12 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $33.11 Typical High $47.86 | Professional | 56 · Pre-op care only | $31.62 | $33.11 | $47.86 |
Where Georgia sits
The same service costs 2.8 times more in Iowa 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· 14th of 51
$603
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.