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 $831.76 Median $831.76 Typical High $1,348.96 | Facility | None | $831.76 | $831.76 | $1,348.96 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $870.96 Typical High $1,318.26 | Professional | None | $831.76 | $870.96 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,041.74 Median $7,079.46 Typical High $7,585.78 | Facility | None | $2,041.74 | $7,079.46 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,778.28 Typical High $6,606.93 | Professional | None | $1,122.02 | $1,778.28 | $6,606.93 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $114.82 Median $257.04 Typical High $1,174.90 | Professional | RR · Rental | $114.82 | $257.04 | $1,174.90 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $851.14 Median $1,905.46 Typical High $8,709.64 | Professional | UE · Used equipment | $851.14 | $1,905.46 | $8,709.64 |
CareSource Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Facility | None | $1,698.24 | $1,698.24 | $1,698.24 |
CareSource Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Facility | None | $1,584.89 | $1,584.89 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $2,754.23 | Professional | None | $1,148.15 | $1,148.15 | $2,754.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,445.44 Median $2,041.74 Typical High $3,548.13 | Professional | None | $1,445.44 | $2,041.74 | $3,548.13 |
United Setting Facility Modifier None Typical Low $794.33 Median $794.33 Typical High $1,071.52 | Facility | None | $794.33 | $794.33 | $1,071.52 |
United Setting Professional Modifier None Typical Low $741.31 Median $1,000.00 Typical High $2,570.40 | Professional | None | $741.31 | $1,000.00 | $2,570.40 |
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 $416.87 Median $436.52 Typical High $660.69 | Professional | 52 · Reduced service | $416.87 | $436.52 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $173.78 Typical High $263.03 | Professional | 53 · Discontinued | $165.96 | $173.78 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $131.83 Typical High $194.98 | Professional | 55 · Aftercare only | $125.89 | $131.83 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $87.10 Typical High $131.83 | Professional | 56 · Pre-op care only | $83.18 | $87.10 | $131.83 |
Where Georgia sits
The same service costs 2.3 times more in Wisconsin 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· 15th of 51
$1,660
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.