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 $363.08 Median $5,370.32 Typical High $10,000.00 | Facility | None | $363.08 | $5,370.32 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $1,412.54 | Professional | None | $363.08 | $363.08 | $1,412.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $707.95 Median $1,778.28 Typical High $7,585.78 | Facility | None | $707.95 | $1,778.28 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $407.38 Median $446.68 Typical High $1,202.26 | Professional | None | $407.38 | $446.68 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $758.58 Typical High $4,265.80 | Facility | None | $501.19 | $758.58 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $363.08 Median $501.19 Typical High $1,737.80 | Professional | None | $363.08 | $501.19 | $1,737.80 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $2,884.03 Typical High $8,709.64 | Facility | None | $1,258.93 | $2,884.03 | $8,709.64 |
United Setting Professional Modifier None Typical Low $275.42 Median $436.52 Typical High $812.83 | Professional | None | $275.42 | $436.52 | $812.83 |
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 $181.97 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $74.13 Typical High $74.13 | Professional | 53 · Discontinued | $72.44 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $275.42 Typical High $275.42 | Professional | 54 · Surgery only | $269.15 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $54.95 Typical High $54.95 | Professional | 55 · Aftercare only | $53.70 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $36.31 |
Where Georgia sits
The same service costs 7.8 times more in Texas than in Delaware. 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· 19th of 51
$977
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.