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 $7,585.78 Median $7,585.78 Typical High $12,022.64 | Facility | None | $7,585.78 | $7,585.78 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $7,585.78 Median $8,128.31 Typical High $11,481.54 | Professional | None | $7,585.78 | $8,128.31 | $11,481.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $18,197.01 Median $63,095.73 Typical High $67,608.30 | Facility | None | $18,197.01 | $63,095.73 | $67,608.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $10,000.00 Median $15,848.93 Typical High $58,884.37 | Professional | None | $10,000.00 | $15,848.93 | $58,884.37 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1,071.52 Median $2,398.83 Typical High $10,964.78 | Professional | RR · Rental | $1,071.52 | $2,398.83 | $10,964.78 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $7,943.28 Median $17,782.79 Typical High $81,283.05 | Professional | UE · Used equipment | $7,943.28 | $17,782.79 | $81,283.05 |
CareSource Setting Facility Modifier None Typical Low $15,488.17 Median $15,488.17 Typical High $15,488.17 | Facility | None | $15,488.17 | $15,488.17 | $15,488.17 |
CareSource Setting Professional Modifier None Typical Low $15,488.17 Median $15,488.17 Typical High $15,488.17 | Professional | None | $15,488.17 | $15,488.17 | $15,488.17 |
Cigna Setting Facility Modifier None Typical Low $12,589.25 Median $12,589.25 Typical High $12,589.25 | Facility | None | $12,589.25 | $12,589.25 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $24,547.09 | Professional | None | $9,120.11 | $9,120.11 | $24,547.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $12,882.50 Median $18,197.01 Typical High $33,113.11 | Professional | None | $12,882.50 | $18,197.01 | $33,113.11 |
United Setting Facility Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $9,332.54 | Facility | None | $7,943.28 | $7,943.28 | $9,332.54 |
United Setting Professional Modifier None Typical Low $6,760.83 Median $8,912.51 Typical High $22,908.68 | Professional | None | $6,760.83 | $8,912.51 | $22,908.68 |
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 $3,801.89 Median $4,073.80 Typical High $5,754.40 | Professional | 52 · Reduced service | $3,801.89 | $4,073.80 | $5,754.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,513.56 Median $1,621.81 Typical High $2,290.87 | Professional | 53 · Discontinued | $1,513.56 | $1,621.81 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,122.02 Median $1,202.26 Typical High $1,698.24 | Professional | 55 · Aftercare only | $1,122.02 | $1,202.26 | $1,698.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $758.58 Median $812.83 Typical High $1,148.15 | Professional | 56 · Pre-op care only | $758.58 | $812.83 | $1,148.15 |
Where Georgia sits
The same service costs 2.5 times more in Montana than in Florida. 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
$15,136
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.