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 $478.63 Median $5,623.41 Typical High $10,000.00 | Facility | None | $478.63 | $5,623.41 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $478.63 Typical High $4,466.84 | Professional | None | $467.74 | $478.63 | $4,466.84 |
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 $524.81 Median $758.58 Typical High $851.14 | Professional | None | $524.81 | $758.58 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $20,892.96 Typical High $26,302.68 | Facility | None | $602.56 | $20,892.96 | $26,302.68 |
Kaiser Permanente Setting Professional Modifier None Typical Low $724.44 Median $758.58 Typical High $1,202.26 | Professional | None | $724.44 | $758.58 | $1,202.26 |
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 $524.81 Median $831.76 Typical High $1,737.80 | Professional | None | $524.81 | $831.76 | $1,737.80 |
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 $234.42 Median $239.88 Typical High $239.88 | Professional | 52 · Reduced service | $234.42 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $95.50 Typical High $95.50 | Professional | 53 · Discontinued | $93.33 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | 54 · Surgery only | $354.81 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $72.44 Typical High $72.44 | Professional | 55 · Aftercare only | $70.79 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $47.86 Typical High $47.86 | Professional | 56 · Pre-op care only | $46.77 | $47.86 | $47.86 |
Where Georgia sits
The same service costs 29.5 times more in Louisiana than in Maine. 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· 39th of 51
$851
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.