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 $4,265.80 Median $4,265.80 Typical High $6,760.83 | Facility | None | $4,265.80 | $4,265.80 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $4,265.80 Median $4,570.88 Typical High $6,456.54 | Professional | None | $4,265.80 | $4,570.88 | $6,456.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $5,495.41 Median $8,511.38 Typical High $30,199.52 | Professional | None | $5,495.41 | $8,511.38 | $30,199.52 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $741.31 Median $1,230.27 Typical High $5,623.41 | Professional | RR · Rental | $741.31 | $1,230.27 | $5,623.41 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $5,495.41 Median $8,128.31 Typical High $42,657.95 | Professional | UE · Used equipment | $5,495.41 | $8,128.31 | $42,657.95 |
CareSource Setting Facility Modifier None Typical Low $8,511.38 Median $8,511.38 Typical High $8,511.38 | Facility | None | $8,511.38 | $8,511.38 | $8,511.38 |
CareSource Setting Professional Modifier None Typical Low $8,511.38 Median $8,511.38 Typical High $8,511.38 | Professional | None | $8,511.38 | $8,511.38 | $8,511.38 |
Cigna Setting Facility Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $5,623.41 | Facility | None | $5,623.41 | $5,623.41 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $13,803.84 | Professional | None | $4,786.30 | $4,786.30 | $13,803.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $7,244.36 Median $10,232.93 Typical High $16,595.87 | Professional | None | $7,244.36 | $10,232.93 | $16,595.87 |
United Setting Professional Modifier None Typical Low $3,548.13 Median $5,128.61 Typical High $12,882.50 | Professional | None | $3,548.13 | $5,128.61 | $12,882.50 |
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 $2,089.30 Median $2,238.72 Typical High $3,235.94 | Professional | 52 · Reduced service | $2,089.30 | $2,238.72 | $3,235.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $851.14 Median $891.25 Typical High $1,288.25 | Professional | 53 · Discontinued | $851.14 | $891.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $630.96 Median $660.69 Typical High $954.99 | Professional | 55 · Aftercare only | $630.96 | $660.69 | $954.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $426.58 Median $446.68 Typical High $645.65 | Professional | 56 · Pre-op care only | $426.58 | $446.68 | $645.65 |
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
$8,511
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.