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 $1,621.81 Median $1,621.81 Typical High $2,570.40 | Facility | None | $1,621.81 | $1,621.81 | $2,570.40 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,737.80 Typical High $2,454.71 | Professional | None | $1,621.81 | $1,737.80 | $2,454.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,981.07 Median $13,803.84 Typical High $14,454.40 | Facility | None | $3,981.07 | $13,803.84 | $14,454.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,187.76 Median $3,467.37 Typical High $12,882.50 | Professional | None | $2,187.76 | $3,467.37 | $12,882.50 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $223.87 Median $501.19 Typical High $2,290.87 | Professional | RR · Rental | $223.87 | $501.19 | $2,290.87 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,698.24 Median $3,801.89 Typical High $17,378.01 | Professional | UE · Used equipment | $1,698.24 | $3,801.89 | $17,378.01 |
CareSource Setting Facility Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Facility | None | $3,311.31 | $3,311.31 | $3,311.31 |
CareSource Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Professional | None | $3,311.31 | $3,311.31 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Facility | None | $2,951.21 | $2,951.21 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $5,370.32 | Professional | None | $2,187.76 | $2,187.76 | $5,370.32 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,754.23 Median $3,981.07 Typical High $6,918.31 | Professional | None | $2,754.23 | $3,981.07 | $6,918.31 |
United Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,951.21 | Facility | None | $2,041.74 | $2,041.74 | $2,951.21 |
United Setting Professional Modifier None Typical Low $1,445.44 Median $1,949.84 Typical High $5,011.87 | Professional | None | $1,445.44 | $1,949.84 | $5,011.87 |
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 $812.83 Median $870.96 Typical High $1,230.27 | Professional | 52 · Reduced service | $812.83 | $870.96 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $346.74 Typical High $489.78 | Professional | 53 · Discontinued | $323.59 | $346.74 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $263.03 Typical High $371.54 | Professional | 55 · Aftercare only | $245.47 | $263.03 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $173.78 Typical High $245.47 | Professional | 56 · Pre-op care only | $162.18 | $173.78 | $245.47 |
Where Georgia sits
The same service costs 2.5 times more in Montana 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
$3,236
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.