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 $1,862.09 Median $1,862.09 Typical High $2,951.21 | Facility | None | $1,862.09 | $1,862.09 | $2,951.21 |
Aetna Setting Professional Modifier None Typical Low $1,862.09 Median $1,995.26 Typical High $2,818.38 | Professional | None | $1,862.09 | $1,995.26 | $2,818.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,570.88 Median $15,848.93 Typical High $16,595.87 | Facility | None | $4,570.88 | $15,848.93 | $16,595.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,454.71 Median $3,715.35 Typical High $12,882.50 | Professional | None | $2,454.71 | $3,715.35 | $12,882.50 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $269.15 Median $602.56 Typical High $2,754.23 | Professional | RR · Rental | $269.15 | $602.56 | $2,754.23 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2,041.74 Median $4,570.88 Typical High $20,892.96 | Professional | UE · Used equipment | $2,041.74 | $4,570.88 | $20,892.96 |
CareSource Setting Facility Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $3,801.89 | Facility | None | $3,801.89 | $3,801.89 | $3,801.89 |
CareSource Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $3,801.89 | Professional | None | $3,801.89 | $3,801.89 | $3,801.89 |
Cigna Setting Facility Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Facility | None | $2,754.23 | $2,754.23 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $6,025.60 | Professional | None | $2,041.74 | $2,041.74 | $6,025.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,162.28 Median $4,570.88 Typical High $6,456.54 | Professional | None | $3,162.28 | $4,570.88 | $6,456.54 |
United Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,511.89 | Facility | None | $2,454.71 | $2,454.71 | $2,511.89 |
United Setting Professional Modifier None Typical Low $1,737.80 Median $2,238.72 Typical High $5,754.40 | Professional | None | $1,737.80 | $2,238.72 | $5,754.40 |
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 $933.25 Median $1,000.00 Typical High $1,412.54 | Professional | 52 · Reduced service | $933.25 | $1,000.00 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $398.11 Typical High $562.34 | Professional | 53 · Discontinued | $371.54 | $398.11 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $302.00 Typical High $426.58 | Professional | 55 · Aftercare only | $275.42 | $302.00 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $199.53 Typical High $281.84 | Professional | 56 · Pre-op care only | $186.21 | $199.53 | $281.84 |
Where Georgia sits
The same service costs 2.8 times more in Wyoming 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· 21st of 51
$3,311
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.