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 $954.99 Median $954.99 Typical High $1,513.56 | Facility | None | $954.99 | $954.99 | $1,513.56 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,023.29 Typical High $1,513.56 | Professional | None | $954.99 | $1,023.29 | $1,513.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,344.23 Median $8,128.31 Typical High $8,511.38 | Facility | None | $2,344.23 | $8,128.31 | $8,511.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,995.26 Typical High $7,585.78 | Professional | None | $1,258.93 | $1,995.26 | $7,585.78 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $138.04 Median $309.03 Typical High $1,412.54 | Professional | RR · Rental | $138.04 | $309.03 | $1,412.54 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,023.29 Median $2,344.23 Typical High $10,715.19 | Professional | UE · Used equipment | $1,023.29 | $2,344.23 | $10,715.19 |
CareSource Setting Facility Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Facility | None | $1,949.84 | $1,949.84 | $1,949.84 |
CareSource Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,949.84 | $1,949.84 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,412.54 | $1,412.54 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $3,090.30 | Professional | None | $1,047.13 | $1,047.13 | $3,090.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,621.81 Median $2,344.23 Typical High $4,265.80 | Professional | None | $1,621.81 | $2,344.23 | $4,265.80 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,513.56 | Facility | None | $1,348.96 | $1,348.96 | $1,513.56 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,148.15 Typical High $2,884.03 | Professional | None | $891.25 | $1,148.15 | $2,884.03 |
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 $478.63 Median $512.86 Typical High $758.58 | Professional | 52 · Reduced service | $478.63 | $512.86 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $204.17 Typical High $302.00 | Professional | 53 · Discontinued | $190.55 | $204.17 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $151.36 Typical High $229.09 | Professional | 55 · Aftercare only | $141.25 | $151.36 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $102.33 Typical High $151.36 | Professional | 56 · Pre-op care only | $95.50 | $102.33 | $151.36 |
Where Georgia sits
The same service costs 3.2 times more in Hawaii 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
$1,862
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.