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 $4,466.84 Median $4,466.84 Typical High $7,244.36 | Facility | None | $4,466.84 | $4,466.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $4,466.84 Median $4,677.35 Typical High $6,760.83 | Professional | None | $4,466.84 | $4,677.35 | $6,760.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,964.78 Median $38,018.94 Typical High $40,738.03 | Facility | None | $10,964.78 | $38,018.94 | $40,738.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $5,623.41 Median $9,549.93 Typical High $35,481.34 | Professional | None | $5,623.41 | $9,549.93 | $35,481.34 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $562.34 Median $1,258.93 Typical High $5,754.40 | Professional | RR · Rental | $562.34 | $1,258.93 | $5,754.40 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4,265.80 Median $9,332.54 Typical High $42,657.95 | Professional | UE · Used equipment | $4,265.80 | $9,332.54 | $42,657.95 |
CareSource Setting Facility Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $9,120.11 | Facility | None | $9,120.11 | $9,120.11 | $9,120.11 |
CareSource Setting Professional Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $9,120.11 | Professional | None | $9,120.11 | $9,120.11 | $9,120.11 |
Cigna Setting Facility Modifier None Typical Low $7,244.36 Median $7,244.36 Typical High $7,244.36 | Facility | None | $7,244.36 | $7,244.36 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $14,791.08 | Professional | None | $5,248.07 | $5,248.07 | $14,791.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $7,762.47 Median $10,964.78 Typical High $17,782.79 | Professional | None | $7,762.47 | $10,964.78 | $17,782.79 |
United Setting Facility Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $5,128.61 | Facility | None | $4,365.16 | $4,365.16 | $5,128.61 |
United Setting Professional Modifier None Typical Low $3,630.78 Median $5,370.32 Typical High $13,803.84 | Professional | None | $3,630.78 | $5,370.32 | $13,803.84 |
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 $2,238.72 Median $2,344.23 Typical High $3,388.44 | Professional | 52 · Reduced service | $2,238.72 | $2,344.23 | $3,388.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $891.25 Median $933.25 Typical High $1,380.38 | Professional | 53 · Discontinued | $891.25 | $933.25 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $676.08 Median $707.95 Typical High $1,023.29 | Professional | 55 · Aftercare only | $676.08 | $707.95 | $1,023.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $446.68 Median $467.74 Typical High $676.08 | Professional | 56 · Pre-op care only | $446.68 | $467.74 | $676.08 |
Where Georgia sits
The same service costs 2.1 times more in Hawaii than in New Jersey. 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· 10th of 51
$8,913
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.