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 $234.42 Median $234.42 Typical High $371.54 | Facility | None | $234.42 | $234.42 | $371.54 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $245.47 Typical High $354.81 | Professional | None | $234.42 | $245.47 | $354.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $1,995.26 Typical High $2,089.30 | Facility | None | $575.44 | $1,995.26 | $2,089.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $501.19 Typical High $1,862.09 | Professional | None | $302.00 | $501.19 | $1,862.09 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $30.90 Median $67.61 Typical High $309.03 | Professional | RR · Rental | $30.90 | $67.61 | $309.03 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $229.09 Median $512.86 Typical High $2,344.23 | Professional | UE · Used equipment | $229.09 | $512.86 | $2,344.23 |
CareSource Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
CareSource Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $776.25 | Professional | None | $263.03 | $263.03 | $776.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $398.11 Median $575.44 Typical High $812.83 | Professional | None | $398.11 | $575.44 | $812.83 |
United Setting Professional Modifier None Typical Low $194.98 Median $281.84 Typical High $724.44 | Professional | None | $194.98 | $281.84 | $724.44 |
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 $117.49 Median $123.03 Typical High $177.83 | Professional | 52 · Reduced service | $117.49 | $123.03 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $48.98 Typical High $70.79 | Professional | 53 · Discontinued | $46.77 | $48.98 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $37.15 Typical High $53.70 | Professional | 55 · Aftercare only | $35.48 | $37.15 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $24.55 Typical High $35.48 | Professional | 56 · Pre-op care only | $23.44 | $24.55 | $35.48 |
Where Georgia sits
The same service costs 2.2 times more in Montana 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· 12th of 51
$468
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.