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 $1,348.96 Median $1,348.96 Typical High $2,187.76 | Facility | None | $1,348.96 | $1,348.96 | $2,187.76 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,479.11 Typical High $2,187.76 | Professional | None | $1,348.96 | $1,479.11 | $2,187.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,311.31 Median $11,481.54 Typical High $12,302.69 | Facility | None | $3,311.31 | $11,481.54 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,819.70 Median $2,884.03 Typical High $20,417.38 | Professional | None | $1,819.70 | $2,884.03 | $20,417.38 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $199.53 Median $446.68 Typical High $2,041.74 | Professional | RR · Rental | $199.53 | $446.68 | $2,041.74 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,513.56 Median $3,311.31 Typical High $15,135.61 | Professional | UE · Used equipment | $1,513.56 | $3,311.31 | $15,135.61 |
CareSource Setting Facility Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Facility | None | $2,754.23 | $2,754.23 | $2,754.23 |
CareSource Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,754.23 | $2,754.23 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Facility | None | $2,691.53 | $2,691.53 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $4,466.84 | Professional | None | $1,949.84 | $1,949.84 | $4,466.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,344.23 Median $3,311.31 Typical High $6,165.95 | Professional | None | $2,344.23 | $3,311.31 | $6,165.95 |
United Setting Facility Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,187.76 | Facility | None | $1,862.09 | $1,862.09 | $2,187.76 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $1,621.81 Typical High $4,168.69 | Professional | None | $1,288.25 | $1,621.81 | $4,168.69 |
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 $676.08 Median $724.44 Typical High $1,096.48 | Professional | 52 · Reduced service | $676.08 | $724.44 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $295.12 Typical High $436.52 | Professional | 53 · Discontinued | $275.42 | $295.12 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $218.78 Typical High $331.13 | Professional | 55 · Aftercare only | $204.17 | $218.78 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $147.91 Typical High $218.78 | Professional | 56 · Pre-op care only | $134.90 | $147.91 | $218.78 |
Where Georgia sits
The same service costs 2.9 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· 17th of 51
$2,692
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.