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 $346.74 Median $7,244.36 Typical High $12,302.69 | Facility | None | $346.74 | $7,244.36 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $5,370.32 | Professional | None | $346.74 | $346.74 | $5,370.32 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,348.96 Median $3,090.30 Typical High $15,848.93 | Facility | None | $1,348.96 | $3,090.30 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $288.40 Median $363.08 Typical High $562.34 | Professional | None | $288.40 | $363.08 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $21,379.62 Typical High $27,542.29 | Facility | None | $602.56 | $21,379.62 | $27,542.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $457.09 Median $478.63 Typical High $741.31 | Professional | None | $457.09 | $478.63 | $741.31 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $16,218.10 Typical High $35,481.34 | Facility | None | $1,513.56 | $16,218.10 | $35,481.34 |
United Setting Professional Modifier None Typical Low $380.19 Median $602.56 Typical High $1,230.27 | Professional | None | $380.19 | $602.56 | $1,230.27 |
5 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 $173.78 Median $173.78 Typical High $173.78 | Professional | 52 · Reduced service | $173.78 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 53 · Discontinued | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $263.03 Typical High $263.03 | Professional | 54 · Surgery only | $257.04 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $52.48 Typical High $52.48 | Professional | 55 · Aftercare only | $51.29 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | 56 · Pre-op care only | $34.67 | $34.67 | $34.67 |
Where Georgia sits
The same service costs 63.1 times more in Arkansas 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· 31st of 51
$832
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.