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 $16,218.10 Median $16,218.10 Typical High $26,302.68 | Facility | None | $16,218.10 | $16,218.10 | $26,302.68 |
Aetna Setting Professional Modifier None Typical Low $16,218.10 Median $17,378.01 Typical High $26,302.68 | Professional | None | $16,218.10 | $17,378.01 | $26,302.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $39,810.72 Median $138,038.43 Typical High $147,910.84 | Facility | None | $39,810.72 | $138,038.43 | $147,910.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $21,877.62 Median $34,673.69 Typical High $128,824.96 | Professional | None | $21,877.62 | $34,673.69 | $128,824.96 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2,398.83 Median $5,370.32 Typical High $24,547.09 | Professional | RR · Rental | $2,398.83 | $5,370.32 | $24,547.09 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $17,782.79 Median $39,810.72 Typical High $181,970.09 | Professional | UE · Used equipment | $17,782.79 | $39,810.72 | $181,970.09 |
CareSource Setting Facility Modifier None Typical Low $33,113.11 Median $33,113.11 Typical High $33,113.11 | Facility | None | $33,113.11 | $33,113.11 | $33,113.11 |
CareSource Setting Professional Modifier None Typical Low $33,113.11 Median $33,113.11 Typical High $33,113.11 | Professional | None | $33,113.11 | $33,113.11 | $33,113.11 |
Cigna Setting Facility Modifier None Typical Low $30,199.52 Median $30,199.52 Typical High $30,199.52 | Facility | None | $30,199.52 | $30,199.52 | $30,199.52 |
Cigna Setting Professional Modifier None Typical Low $22,387.21 Median $22,387.21 Typical High $53,703.18 | Professional | None | $22,387.21 | $22,387.21 | $53,703.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $28,183.83 Median $39,810.72 Typical High $74,131.02 | Professional | None | $28,183.83 | $39,810.72 | $74,131.02 |
United Setting Professional Modifier None Typical Low $15,488.17 Median $19,498.45 Typical High $50,118.72 | Professional | None | $15,488.17 | $19,498.45 | $50,118.72 |
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 $8,128.31 Median $8,709.64 Typical High $13,182.57 | Professional | 52 · Reduced service | $8,128.31 | $8,709.64 | $13,182.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3,235.94 Median $3,548.13 Typical High $5,248.07 | Professional | 53 · Discontinued | $3,235.94 | $3,548.13 | $5,248.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2,454.71 Median $2,630.27 Typical High $3,890.45 | Professional | 55 · Aftercare only | $2,454.71 | $2,630.27 | $3,890.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1,621.81 Median $1,737.80 Typical High $2,630.27 | Professional | 56 · Pre-op care only | $1,621.81 | $1,737.80 | $2,630.27 |
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· 17th of 51
$32,359
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.