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 $1,548.82 | Facility | None | $954.99 | $954.99 | $1,548.82 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,023.29 Typical High $1,548.82 | Professional | None | $954.99 | $1,023.29 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,344.23 Median $8,128.31 Typical High $8,709.64 | Facility | None | $2,344.23 | $8,128.31 | $8,709.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,288.25 Median $1,905.46 Typical High $6,606.93 | Professional | None | $1,288.25 | $1,905.46 | $6,606.93 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $138.04 Median $316.23 Typical High $1,445.44 | Professional | RR · Rental | $138.04 | $316.23 | $1,445.44 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,047.13 Median $2,344.23 Typical High $10,715.19 | Professional | UE · Used equipment | $1,047.13 | $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 $1,949.84 Median $1,949.84 Typical High $1,949.84 | Facility | None | $1,949.84 | $1,949.84 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $3,162.28 | Professional | None | $1,445.44 | $1,445.44 | $3,162.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,659.59 Median $2,344.23 Typical High $4,365.16 | Professional | None | $1,659.59 | $2,344.23 | $4,365.16 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,258.93 | Facility | None | $1,096.48 | $1,096.48 | $1,258.93 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,148.15 Typical High $2,951.21 | Professional | None | $912.01 | $1,148.15 | $2,951.21 |
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 $776.25 | Professional | 52 · Reduced service | $478.63 | $512.86 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $208.93 Typical High $309.03 | Professional | 53 · Discontinued | $190.55 | $208.93 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $154.88 Typical High $229.09 | Professional | 55 · Aftercare only | $144.54 | $154.88 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $102.33 Typical High $154.88 | Professional | 56 · Pre-op care only | $95.50 | $102.33 | $154.88 |
Where Georgia sits
The same service costs 2.4 times more in Minnesota than in Washington, DC. 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
$1,820
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.