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 $3,715.35 Median $3,715.35 Typical High $5,888.44 | Facility | None | $3,715.35 | $3,715.35 | $5,888.44 |
Aetna Setting Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $5,623.41 | Professional | None | $3,715.35 | $3,715.35 | $5,623.41 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,120.11 Median $31,622.78 Typical High $33,113.11 | Facility | None | $9,120.11 | $31,622.78 | $33,113.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $4,265.80 Median $7,943.28 Typical High $29,512.09 | Professional | None | $4,265.80 | $7,943.28 | $29,512.09 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $426.58 Median $954.99 Typical High $4,365.16 | Professional | RR · Rental | $426.58 | $954.99 | $4,365.16 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3,235.94 Median $7,244.36 Typical High $32,359.37 | Professional | UE · Used equipment | $3,235.94 | $7,244.36 | $32,359.37 |
CareSource Setting Facility Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $7,585.78 | Facility | None | $7,585.78 | $7,585.78 | $7,585.78 |
CareSource Setting Professional Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $7,585.78 | Professional | None | $7,585.78 | $7,585.78 | $7,585.78 |
Cigna Setting Facility Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Facility | None | $4,677.35 | $4,677.35 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $12,302.69 | Professional | None | $3,467.37 | $3,467.37 | $12,302.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $6,309.57 Median $9,120.11 Typical High $13,489.63 | Professional | None | $6,309.57 | $9,120.11 | $13,489.63 |
United Setting Facility Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $3,548.13 | Facility | None | $2,884.03 | $2,884.03 | $3,548.13 |
United Setting Professional Modifier None Typical Low $2,951.21 Median $4,466.84 Typical High $11,481.54 | Professional | None | $2,951.21 | $4,466.84 | $11,481.54 |
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 $1,862.09 Median $1,862.09 Typical High $2,818.38 | Professional | 52 · Reduced service | $1,862.09 | $1,862.09 | $2,818.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $741.31 Median $758.58 Typical High $1,122.02 | Professional | 53 · Discontinued | $741.31 | $758.58 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $562.34 Median $562.34 Typical High $851.14 | Professional | 55 · Aftercare only | $562.34 | $562.34 | $851.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $371.54 Median $371.54 Typical High $562.34 | Professional | 56 · Pre-op care only | $371.54 | $371.54 | $562.34 |
Where Georgia sits
The same service costs 2.3 times more in Arkansas than in Vermont. 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· 4th of 51
$7,413
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.