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 $1,949.84 Median $1,949.84 Typical High $3,090.30 | Facility | None | $1,949.84 | $1,949.84 | $3,090.30 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $2,089.30 Typical High $3,090.30 | Professional | None | $1,949.84 | $2,089.30 | $3,090.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $16,595.87 Typical High $17,378.01 | Facility | None | $4,786.30 | $16,595.87 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,630.27 Median $4,168.69 Typical High $15,488.17 | Professional | None | $2,630.27 | $4,168.69 | $15,488.17 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $281.84 Median $616.60 Typical High $2,818.38 | Professional | RR · Rental | $281.84 | $616.60 | $2,818.38 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2,089.30 Median $4,677.35 Typical High $21,379.62 | Professional | UE · Used equipment | $2,089.30 | $4,677.35 | $21,379.62 |
CareSource Setting Facility Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Facility | None | $3,981.07 | $3,981.07 | $3,981.07 |
CareSource Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Professional | None | $3,981.07 | $3,981.07 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Facility | None | $3,548.13 | $3,548.13 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $6,456.54 | Professional | None | $2,570.40 | $2,570.40 | $6,456.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,311.31 Median $4,786.30 Typical High $8,511.38 | Professional | None | $3,311.31 | $4,786.30 | $8,511.38 |
United Setting Facility Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,890.45 | Facility | None | $3,019.95 | $3,019.95 | $3,890.45 |
United Setting Professional Modifier None Typical Low $1,778.28 Median $2,344.23 Typical High $6,025.60 | Professional | None | $1,778.28 | $2,344.23 | $6,025.60 |
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 $977.24 Median $1,047.13 Typical High $1,548.82 | Professional | 52 · Reduced service | $977.24 | $1,047.13 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $416.87 Typical High $616.60 | Professional | 53 · Discontinued | $389.05 | $416.87 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $316.23 Typical High $467.74 | Professional | 55 · Aftercare only | $295.12 | $316.23 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $208.93 Typical High $309.03 | Professional | 56 · Pre-op care only | $194.98 | $208.93 | $309.03 |
Where Georgia sits
The same service costs 3.0 times more in Hawaii than in Pennsylvania. 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
$3,890
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.