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 $1,202.26 Median $1,202.26 Typical High $1,905.46 | Facility | None | $1,202.26 | $1,202.26 | $1,905.46 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,288.25 Typical High $1,905.46 | Professional | None | $1,202.26 | $1,288.25 | $1,905.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $10,000.00 Typical High $10,715.19 | Facility | None | $2,884.03 | $10,000.00 | $10,715.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,584.89 Median $2,511.89 Typical High $10,964.78 | Professional | None | $1,584.89 | $2,511.89 | $10,964.78 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $173.78 Median $389.05 Typical High $1,778.28 | Professional | RR · Rental | $173.78 | $389.05 | $1,778.28 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,318.26 Median $2,884.03 Typical High $13,182.57 | Professional | UE · Used equipment | $1,318.26 | $2,884.03 | $13,182.57 |
CareSource Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Facility | None | $2,454.71 | $2,454.71 | $2,454.71 |
CareSource Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
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 $1,288.25 Median $1,288.25 Typical High $3,890.45 | Professional | None | $1,288.25 | $1,288.25 | $3,890.45 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,041.74 Median $2,884.03 Typical High $5,370.32 | Professional | None | $2,041.74 | $2,884.03 | $5,370.32 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,862.09 | Facility | None | $1,621.81 | $1,621.81 | $1,862.09 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,412.54 Typical High $3,630.78 | Professional | None | $1,122.02 | $1,412.54 | $3,630.78 |
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 $588.84 Median $645.65 Typical High $954.99 | Professional | 52 · Reduced service | $588.84 | $645.65 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $257.04 Typical High $380.19 | Professional | 53 · Discontinued | $239.88 | $257.04 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $190.55 Typical High $288.40 | Professional | 55 · Aftercare only | $177.83 | $190.55 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $128.82 Typical High $190.55 | Professional | 56 · Pre-op care only | $120.23 | $128.82 | $190.55 |
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· 17th of 51
$2,344
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.