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 $302.00 Median $302.00 Typical High $489.78 | Facility | None | $302.00 | $302.00 | $489.78 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $316.23 Typical High $457.09 | Professional | None | $302.00 | $316.23 | $457.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $2,570.40 Typical High $2,754.23 | Facility | None | $741.31 | $2,570.40 | $2,754.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $645.65 Typical High $2,398.83 | Professional | None | $389.05 | $645.65 | $2,398.83 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $38.90 Median $87.10 Typical High $398.11 | Professional | RR · Rental | $38.90 | $87.10 | $398.11 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $295.12 Median $645.65 Typical High $2,951.21 | Professional | UE · Used equipment | $295.12 | $645.65 | $2,951.21 |
CareSource Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Facility | None | $616.60 | $616.60 | $616.60 |
CareSource Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $1,000.00 | Professional | None | $302.00 | $302.00 | $1,000.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $524.81 Median $741.31 Typical High $1,230.27 | Professional | None | $524.81 | $741.31 | $1,230.27 |
United Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $467.74 | Facility | None | $426.58 | $426.58 | $467.74 |
United Setting Professional Modifier None Typical Low $251.19 Median $363.08 Typical High $933.25 | Professional | None | $251.19 | $363.08 | $933.25 |
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 $151.36 Median $158.49 Typical High $229.09 | Professional | 52 · Reduced service | $151.36 | $158.49 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $63.10 Typical High $93.33 | Professional | 53 · Discontinued | $60.26 | $63.10 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $47.86 Typical High $69.18 | Professional | 55 · Aftercare only | $45.71 | $47.86 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $31.62 Typical High $45.71 | Professional | 56 · Pre-op care only | $30.20 | $31.62 | $45.71 |
Where Georgia sits
The same service costs 3.9 times more in Hawaii than in Delaware. 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· 13th of 51
$603
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.