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 $891.25 Median $891.25 Typical High $1,412.54 | Facility | None | $891.25 | $891.25 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $933.25 Typical High $1,348.96 | Professional | None | $891.25 | $933.25 | $1,348.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,187.76 Median $7,585.78 Typical High $7,943.28 | Facility | None | $2,187.76 | $7,585.78 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,905.46 Typical High $7,079.46 | Professional | None | $1,096.48 | $1,905.46 | $7,079.46 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $109.65 Median $245.47 Typical High $1,122.02 | Professional | RR · Rental | $109.65 | $245.47 | $1,122.02 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $831.76 Median $1,862.09 Typical High $8,511.38 | Professional | UE · Used equipment | $831.76 | $1,862.09 | $8,511.38 |
CareSource Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
CareSource Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Facility | None | $1,122.02 | $1,122.02 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $2,951.21 | Professional | None | $831.76 | $831.76 | $2,951.21 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,513.56 Median $2,187.76 Typical High $3,467.37 | Professional | None | $1,513.56 | $2,187.76 | $3,467.37 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,202.26 | Facility | None | $1,047.13 | $1,047.13 | $1,202.26 |
United Setting Professional Modifier None Typical Low $707.95 Median $1,071.52 Typical High $2,754.23 | Professional | None | $707.95 | $1,071.52 | $2,754.23 |
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 $446.68 Median $467.74 Typical High $676.08 | Professional | 52 · Reduced service | $446.68 | $467.74 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $186.21 Typical High $269.15 | Professional | 53 · Discontinued | $177.83 | $186.21 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $138.04 Typical High $204.17 | Professional | 55 · Aftercare only | $134.90 | $138.04 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $93.33 Typical High $134.90 | Professional | 56 · Pre-op care only | $89.13 | $93.33 | $134.90 |
Where Georgia sits
The same service costs 3.1 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· 12th of 51
$1,778
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.