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 $380.19 Median $380.19 Typical High $398.11 | Facility | None | $380.19 | $380.19 | $398.11 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $398.11 | Professional | None | $380.19 | $380.19 | $398.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $478.63 Median $1,659.59 Typical High $1,778.28 | Facility | None | $478.63 | $1,659.59 | $1,778.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $269.15 Median $436.52 Typical High $2,754.23 | Professional | None | $269.15 | $436.52 | $2,754.23 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $36.31 Median $60.26 Typical High $275.42 | Professional | RR · Rental | $36.31 | $60.26 | $275.42 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $269.15 Median $363.08 Typical High $2,089.30 | Professional | UE · Used equipment | $269.15 | $363.08 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $389.05 Median $478.63 Typical High $831.76 | Professional | None | $389.05 | $478.63 | $831.76 |
United Setting Professional Modifier None Typical Low $158.49 Median $213.80 Typical High $323.59 | Professional | None | $158.49 | $213.80 | $323.59 |
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 $190.55 Median $190.55 Typical High $194.98 | Professional | 52 · Reduced service | $190.55 | $190.55 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $79.43 | Professional | 53 · Discontinued | $75.86 | $75.86 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $58.88 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $39.81 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $39.81 |
Where Georgia sits
The same service costs 2.8 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· 20th of 51
$398
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.