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 $5,370.32 Median $5,370.32 Typical High $8,511.38 | Facility | None | $5,370.32 | $5,370.32 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $5,370.32 Median $5,754.40 Typical High $8,128.31 | Professional | None | $5,370.32 | $5,754.40 | $8,128.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $13,182.57 Median $45,708.82 Typical High $47,863.01 | Facility | None | $13,182.57 | $45,708.82 | $47,863.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $7,244.36 Median $11,481.54 Typical High $42,657.95 | Professional | None | $7,244.36 | $11,481.54 | $42,657.95 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $741.31 Median $1,659.59 Typical High $7,585.78 | Professional | RR · Rental | $741.31 | $1,659.59 | $7,585.78 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $5,623.41 Median $12,589.25 Typical High $57,543.99 | Professional | UE · Used equipment | $5,623.41 | $12,589.25 | $57,543.99 |
CareSource Setting Facility Modifier None Typical Low $10,964.78 Median $10,964.78 Typical High $10,964.78 | Facility | None | $10,964.78 | $10,964.78 | $10,964.78 |
CareSource Setting Professional Modifier None Typical Low $10,964.78 Median $10,964.78 Typical High $10,964.78 | Professional | None | $10,964.78 | $10,964.78 | $10,964.78 |
Cigna 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 |
Cigna Setting Professional Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $17,782.79 | Professional | None | $6,606.93 | $6,606.93 | $17,782.79 |
Kaiser Permanente Setting Professional Modifier None Typical Low $9,120.11 Median $13,182.57 Typical High $22,908.68 | Professional | None | $9,120.11 | $13,182.57 | $22,908.68 |
United Setting Facility Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $6,165.95 | Facility | None | $5,128.61 | $5,128.61 | $6,165.95 |
United Setting Professional Modifier None Typical Low $4,786.30 Median $6,456.54 Typical High $16,595.87 | Professional | None | $4,786.30 | $6,456.54 | $16,595.87 |
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 $2,691.53 Median $2,818.38 Typical High $4,073.80 | Professional | 52 · Reduced service | $2,691.53 | $2,818.38 | $4,073.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,071.52 Median $1,148.15 Typical High $1,621.81 | Professional | 53 · Discontinued | $1,071.52 | $1,148.15 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $812.83 Median $851.14 Typical High $1,230.27 | Professional | 55 · Aftercare only | $812.83 | $851.14 | $1,230.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $537.03 Median $575.44 Typical High $812.83 | Professional | 56 · Pre-op care only | $537.03 | $575.44 | $812.83 |
Where Georgia sits
The same service costs 2.5 times more in Montana 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· 14th of 51
$10,715
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.