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 $1,122.02 Median $1,122.02 Typical High $1,819.70 | Facility | None | $1,122.02 | $1,122.02 | $1,819.70 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,174.90 Typical High $1,737.80 | Professional | None | $1,122.02 | $1,174.90 | $1,737.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,445.44 Median $2,238.72 Typical High $7,943.28 | Professional | None | $1,445.44 | $2,238.72 | $7,943.28 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $199.53 Median $323.59 Typical High $1,479.11 | Professional | RR · Rental | $199.53 | $323.59 | $1,479.11 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,479.11 Median $2,398.83 Typical High $10,964.78 | Professional | UE · Used equipment | $1,479.11 | $2,398.83 | $10,964.78 |
CareSource Setting Facility Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Facility | None | $2,290.87 | $2,290.87 | $2,290.87 |
CareSource Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Facility | None | $1,479.11 | $1,479.11 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $3,715.35 | Professional | None | $1,258.93 | $1,258.93 | $3,715.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,949.84 Median $2,754.23 Typical High $4,570.88 | Professional | None | $1,949.84 | $2,754.23 | $4,570.88 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,348.96 Typical High $3,467.37 | Professional | None | $933.25 | $1,348.96 | $3,467.37 |
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 $562.34 Median $588.84 Typical High $851.14 | Professional | 52 · Reduced service | $562.34 | $588.84 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $234.42 Typical High $346.74 | Professional | 53 · Discontinued | $223.87 | $234.42 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $177.83 Typical High $257.04 | Professional | 55 · Aftercare only | $169.82 | $177.83 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $117.49 Typical High $173.78 | Professional | 56 · Pre-op care only | $112.20 | $117.49 | $173.78 |
Where Georgia sits
The same service costs 2.6 times more in Montana than in New York. 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· 11th of 51
$2,188
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.