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 $758.58 Median $758.58 Typical High $1,202.26 | Facility | None | $758.58 | $758.58 | $1,202.26 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $794.33 Typical High $1,148.15 | Professional | None | $758.58 | $794.33 | $1,148.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $6,456.54 Typical High $6,760.83 | Facility | None | $1,862.09 | $6,456.54 | $6,760.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,621.81 Typical High $6,025.60 | Professional | None | $1,000.00 | $1,621.81 | $6,025.60 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $100.00 Median $223.87 Typical High $1,023.29 | Professional | RR · Rental | $100.00 | $223.87 | $1,023.29 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $758.58 Median $1,698.24 Typical High $7,762.47 | Professional | UE · Used equipment | $758.58 | $1,698.24 | $7,762.47 |
CareSource Setting Facility Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,548.82 | $1,548.82 | $1,548.82 |
CareSource Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $2,511.89 | Professional | None | $977.24 | $977.24 | $2,511.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,288.25 Median $1,862.09 Typical High $3,090.30 | Professional | None | $1,288.25 | $1,862.09 | $3,090.30 |
United Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $831.76 | Facility | None | $645.65 | $645.65 | $831.76 |
United Setting Professional Modifier None Typical Low $645.65 Median $912.01 Typical High $2,344.23 | Professional | None | $645.65 | $912.01 | $2,344.23 |
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 $380.19 Median $389.05 Typical High $575.44 | Professional | 52 · Reduced service | $380.19 | $389.05 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $158.49 Typical High $229.09 | Professional | 53 · Discontinued | $151.36 | $158.49 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $117.49 Typical High $173.78 | Professional | 55 · Aftercare only | $114.82 | $117.49 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $79.43 Typical High $114.82 | Professional | 56 · Pre-op care only | $75.86 | $79.43 | $114.82 |
Where Georgia sits
The same service costs 2.5 times more in Montana 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· 14th of 51
$1,514
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.