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 $97.72 Median $3,548.13 Typical High $7,585.78 | Facility | None | $97.72 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $100.00 Typical High $275.42 | Professional | None | $66.07 | $100.00 | $275.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $398.11 Median $912.01 Typical High $3,801.89 | Facility | None | $398.11 | $912.01 | $3,801.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $64.57 Median $91.20 Typical High $138.04 | Professional | None | $64.57 | $91.20 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $70.79 Typical High $776.25 | Facility | None | $54.95 | $70.79 | $776.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $57.54 Median $79.43 Typical High $123.03 | Professional | None | $57.54 | $79.43 | $123.03 |
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 $72.44 Median $134.90 Typical High $239.88 | Professional | None | $72.44 | $134.90 | $239.88 |
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 $33.11 Median $35.48 Typical High $50.12 | Professional | 52 · Reduced service | $33.11 | $35.48 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $14.13 Typical High $19.95 | Professional | 53 · Discontinued | $13.18 | $14.13 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $53.70 Typical High $75.86 | Professional | 54 · Surgery only | $48.98 | $53.70 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $10.72 Typical High $15.14 | Professional | 55 · Aftercare only | $9.77 | $10.72 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $7.08 Typical High $10.00 | Professional | 56 · Pre-op care only | $6.61 | $7.08 | $10.00 |
Where Georgia sits
The same service costs 3.4 times more in Alaska than in Virginia. 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· 34th of 51
$105
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.