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 $501.19 | Facility | None | $316.23 | $316.23 | $501.19 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $338.84 Typical High $489.78 | Professional | None | $316.23 | $338.84 | $489.78 |
Ambetter Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
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 $426.58 Median $676.08 Typical High $2,884.03 | Professional | None | $426.58 | $676.08 | $2,884.03 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $45.71 Median $102.33 Typical High $467.74 | Professional | RR · Rental | $45.71 | $102.33 | $467.74 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $346.74 Median $776.25 Typical High $3,548.13 | Professional | UE · Used equipment | $346.74 | $776.25 | $3,548.13 |
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 $660.69 Median $660.69 Typical High $660.69 | Facility | None | $660.69 | $660.69 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $1,047.13 | Professional | None | $489.78 | $489.78 | $1,047.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $537.03 Median $776.25 Typical High $1,096.48 | Professional | None | $537.03 | $776.25 | $1,096.48 |
United Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $549.54 | Facility | None | $501.19 | $501.19 | $549.54 |
United Setting Professional Modifier None Typical Low $295.12 Median $380.19 Typical High $977.24 | Professional | None | $295.12 | $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 $169.82 Typical High $251.19 | Professional | 52 · Reduced service | $158.49 | $169.82 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $67.61 Typical High $102.33 | Professional | 53 · Discontinued | $63.10 | $67.61 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $51.29 Typical High $75.86 | Professional | 55 · Aftercare only | $47.86 | $51.29 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $33.88 Typical High $50.12 | Professional | 56 · Pre-op care only | $31.62 | $33.88 | $50.12 |
Where Georgia sits
The same service costs 4.1 times more in Hawaii than in Kansas. 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· 19th of 51
$631
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.