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 $616.60 Median $616.60 Typical High $977.24 | Facility | None | $616.60 | $616.60 | $977.24 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $660.69 Typical High $954.99 | Professional | None | $616.60 | $660.69 | $954.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $5,128.61 Typical High $5,495.41 | Facility | None | $1,479.11 | $5,128.61 | $5,495.41 |
Anthem BCBS Setting Professional Modifier None Typical Low $812.83 Median $1,288.25 Typical High $4,786.30 | Professional | None | $812.83 | $1,288.25 | $4,786.30 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $85.11 Median $186.21 Typical High $851.14 | Professional | RR · Rental | $85.11 | $186.21 | $851.14 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $630.96 Median $1,412.54 Typical High $6,456.54 | Professional | UE · Used equipment | $630.96 | $1,412.54 | $6,456.54 |
CareSource Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Facility | None | $1,258.93 | $1,258.93 | $1,258.93 |
CareSource Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Facility | None | $1,096.48 | $1,096.48 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,995.26 | Professional | None | $812.83 | $812.83 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,047.13 Median $1,479.11 Typical High $2,570.40 | Professional | None | $1,047.13 | $1,479.11 | $2,570.40 |
Oscar Health Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,995.26 | Professional | None | $1,737.80 | $1,737.80 | $1,995.26 |
United Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $776.25 | Facility | None | $660.69 | $660.69 | $776.25 |
United Setting Professional Modifier None Typical Low $537.03 Median $724.44 Typical High $1,862.09 | Professional | None | $537.03 | $724.44 | $1,862.09 |
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 $302.00 Median $331.13 Typical High $478.63 | Professional | 52 · Reduced service | $302.00 | $331.13 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $131.83 Typical High $190.55 | Professional | 53 · Discontinued | $123.03 | $131.83 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $97.72 Typical High $141.25 | Professional | 55 · Aftercare only | $91.20 | $97.72 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $66.07 Typical High $95.50 | Professional | 56 · Pre-op care only | $61.66 | $66.07 | $95.50 |
Where Georgia sits
The same service costs 2.2 times more in Hawaii than in Florida. 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· 16th of 51
$1,230
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.