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 $3,311.31 Median $3,311.31 Typical High $5,370.32 | Facility | None | $3,311.31 | $3,311.31 | $5,370.32 |
Aetna Setting Professional Modifier None Typical Low $3,311.31 Median $3,548.13 Typical High $5,370.32 | Professional | None | $3,311.31 | $3,548.13 | $5,370.32 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,128.31 Median $28,183.83 Typical High $30,199.52 | Facility | None | $8,128.31 | $28,183.83 | $30,199.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $4,466.84 Median $7,079.46 Typical High $30,199.52 | Professional | None | $4,466.84 | $7,079.46 | $30,199.52 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $489.78 Median $1,096.48 Typical High $5,011.87 | Professional | RR · Rental | $489.78 | $1,096.48 | $5,011.87 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3,630.78 Median $8,128.31 Typical High $37,153.52 | Professional | UE · Used equipment | $3,630.78 | $8,128.31 | $37,153.52 |
CareSource Setting Facility Modifier None Typical Low $6,760.83 Median $6,760.83 Typical High $6,760.83 | Facility | None | $6,760.83 | $6,760.83 | $6,760.83 |
CareSource Setting Professional Modifier None Typical Low $6,760.83 Median $6,760.83 Typical High $6,760.83 | Professional | None | $6,760.83 | $6,760.83 | $6,760.83 |
Cigna Setting Facility Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $6,606.93 | Facility | None | $6,606.93 | $6,606.93 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $10,964.78 | Professional | None | $4,786.30 | $4,786.30 | $10,964.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5,754.40 Median $8,128.31 Typical High $15,135.61 | Professional | None | $5,754.40 | $8,128.31 | $15,135.61 |
United Setting Facility Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $4,466.84 | Facility | None | $3,801.89 | $3,801.89 | $4,466.84 |
United Setting Professional Modifier None Typical Low $3,162.28 Median $3,981.07 Typical High $10,232.93 | Professional | None | $3,162.28 | $3,981.07 | $10,232.93 |
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 $1,659.59 Median $1,778.28 Typical High $2,691.53 | Professional | 52 · Reduced service | $1,659.59 | $1,778.28 | $2,691.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $660.69 Median $724.44 Typical High $1,071.52 | Professional | 53 · Discontinued | $660.69 | $724.44 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $501.19 Median $537.03 Typical High $794.33 | Professional | 55 · Aftercare only | $501.19 | $537.03 | $794.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $331.13 Median $354.81 Typical High $537.03 | Professional | 56 · Pre-op care only | $331.13 | $354.81 | $537.03 |
Where Georgia sits
The same service costs 2.1 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· 17th of 51
$6,607
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.