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 $1,000.00 Median $1,000.00 Typical High $1,621.81 | Facility | None | $1,000.00 | $1,000.00 | $1,621.81 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,071.52 Typical High $1,548.82 | Professional | None | $1,000.00 | $1,071.52 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,454.71 Median $8,511.38 Typical High $9,120.11 | Facility | None | $2,454.71 | $8,511.38 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,348.96 Median $1,995.26 Typical High $6,918.31 | Professional | None | $1,348.96 | $1,995.26 | $6,918.31 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $144.54 Median $295.12 Typical High $1,348.96 | Professional | RR · Rental | $144.54 | $295.12 | $1,348.96 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,096.48 Median $2,187.76 Typical High $10,000.00 | Professional | UE · Used equipment | $1,096.48 | $2,187.76 | $10,000.00 |
CareSource Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Facility | None | $2,041.74 | $2,041.74 | $2,041.74 |
CareSource Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | None | $2,041.74 | $2,041.74 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Facility | None | $1,348.96 | $1,348.96 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $3,311.31 | Professional | None | $977.24 | $977.24 | $3,311.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,737.80 Median $2,454.71 Typical High $3,467.37 | Professional | None | $1,737.80 | $2,454.71 | $3,467.37 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,202.26 Typical High $3,090.30 | Professional | None | $851.14 | $1,202.26 | $3,090.30 |
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 $501.19 Median $524.81 Typical High $776.25 | Professional | 52 · Reduced service | $501.19 | $524.81 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $213.80 Typical High $309.03 | Professional | 53 · Discontinued | $204.17 | $213.80 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $158.49 Typical High $229.09 | Professional | 55 · Aftercare only | $151.36 | $158.49 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $107.15 Typical High $154.88 | Professional | 56 · Pre-op care only | $100.00 | $107.15 | $154.88 |
Where Georgia sits
The same service costs 2.6 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· 18th of 51
$1,778
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.