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 $229.09 Median $5,370.32 Typical High $10,000.00 | Facility | None | $229.09 | $5,370.32 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $229.09 Typical High $1,412.54 | Professional | None | $218.78 | $229.09 | $1,412.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $173.78 Median $234.42 Typical High $389.05 | Professional | None | $173.78 | $234.42 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $724.44 Typical High $2,691.53 | Facility | None | $501.19 | $724.44 | $2,691.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $169.82 Median $239.88 Typical High $1,148.15 | Professional | None | $169.82 | $239.88 | $1,148.15 |
United Setting Facility Modifier None Typical Low $79.43 Median $158.49 Typical High $1,778.28 | Facility | None | $79.43 | $158.49 | $1,778.28 |
United Setting Professional Modifier None Typical Low $218.78 Median $309.03 Typical High $489.78 | Professional | None | $218.78 | $309.03 | $489.78 |
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 $109.65 Median $112.20 Typical High $114.82 | Professional | 52 · Reduced service | $109.65 | $112.20 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $45.71 Typical High $45.71 | Professional | 53 · Discontinued | $43.65 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $169.82 Typical High $169.82 | Professional | 54 · Surgery only | $162.18 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $32.36 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $21.88 | $22.91 | $22.91 |
Where Georgia sits
The same service costs 18.6 times more in Texas 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· 29th of 51
$234
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.