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 $371.54 Median $371.54 Typical High $602.56 | Facility | None | $371.54 | $371.54 | $602.56 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $398.11 Typical High $588.84 | Professional | None | $371.54 | $398.11 | $588.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $912.01 Median $3,162.28 Typical High $3,388.44 | Facility | None | $912.01 | $3,162.28 | $3,388.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $794.33 Typical High $2,951.21 | Professional | None | $501.19 | $794.33 | $2,951.21 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $50.12 Median $112.20 Typical High $512.86 | Professional | RR · Rental | $50.12 | $112.20 | $512.86 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $380.19 Median $851.14 Typical High $3,801.89 | Professional | UE · Used equipment | $380.19 | $851.14 | $3,801.89 |
CareSource Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Facility | None | $758.58 | $758.58 | $758.58 |
CareSource Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Facility | None | $691.83 | $691.83 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $1,230.27 | Professional | None | $512.86 | $512.86 | $1,230.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $645.65 Median $912.01 Typical High $1,548.82 | Professional | None | $645.65 | $912.01 | $1,548.82 |
United Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $501.19 | Facility | None | $398.11 | $398.11 | $501.19 |
United Setting Professional Modifier None Typical Low $323.59 Median $446.68 Typical High $1,148.15 | Professional | None | $323.59 | $446.68 | $1,148.15 |
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 $186.21 Median $199.53 Typical High $295.12 | Professional | 52 · Reduced service | $186.21 | $199.53 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $81.28 Typical High $117.49 | Professional | 53 · Discontinued | $74.13 | $81.28 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $60.26 Typical High $87.10 | Professional | 55 · Aftercare only | $56.23 | $60.26 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $39.81 Typical High $58.88 | Professional | 56 · Pre-op care only | $37.15 | $39.81 | $58.88 |
Where Georgia sits
The same service costs 2.4 times more in Hawaii 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
$741
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.