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 $1,023.29 Median $1,023.29 Typical High $1,621.81 | Facility | None | $1,023.29 | $1,023.29 | $1,621.81 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,096.48 Typical High $1,621.81 | Professional | None | $1,023.29 | $1,096.48 | $1,621.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,511.89 Median $8,709.64 Typical High $9,120.11 | Facility | None | $2,511.89 | $8,709.64 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $2,041.74 Typical High $7,079.46 | Professional | None | $1,380.38 | $2,041.74 | $7,079.46 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $147.91 Median $331.13 Typical High $1,513.56 | Professional | RR · Rental | $147.91 | $331.13 | $1,513.56 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,122.02 Median $2,511.89 Typical High $11,481.54 | Professional | UE · Used equipment | $1,122.02 | $2,511.89 | $11,481.54 |
CareSource Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Facility | None | $2,089.30 | $2,089.30 | $2,089.30 |
CareSource Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Facility | None | $1,778.28 | $1,778.28 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $3,388.44 | Professional | None | $1,318.26 | $1,318.26 | $3,388.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,737.80 Median $2,511.89 Typical High $4,570.88 | Professional | None | $1,737.80 | $2,511.89 | $4,570.88 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,621.81 | Facility | None | $1,445.44 | $1,445.44 | $1,621.81 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,230.27 Typical High $3,162.28 | Professional | None | $954.99 | $1,230.27 | $3,162.28 |
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 $512.86 Median $549.54 Typical High $812.83 | Professional | 52 · Reduced service | $512.86 | $549.54 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $218.78 Typical High $323.59 | Professional | 53 · Discontinued | $204.17 | $218.78 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $165.96 Typical High $245.47 | Professional | 55 · Aftercare only | $151.36 | $165.96 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $109.65 Typical High $162.18 | Professional | 56 · Pre-op care only | $102.33 | $109.65 | $162.18 |
Where Georgia sits
The same service costs 2.8 times more in Hawaii 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· 20th 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.