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 $338.84 Median $5,623.41 Typical High $10,000.00 | Facility | None | $338.84 | $5,623.41 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $338.84 Typical High $4,466.84 | Professional | None | $331.13 | $338.84 | $4,466.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $12,022.64 | Facility | None | $1,122.02 | $2,754.23 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $489.78 Typical High $562.34 | Professional | None | $389.05 | $489.78 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $8,317.64 Typical High $10,715.19 | Facility | None | $602.56 | $8,317.64 | $10,715.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $446.68 Median $467.74 Typical High $741.31 | Professional | None | $446.68 | $467.74 | $741.31 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $6,760.83 Typical High $12,882.50 | Facility | None | $1,513.56 | $6,760.83 | $12,882.50 |
United Setting Professional Modifier None Typical Low $338.84 Median $549.54 Typical High $1,202.26 | Professional | None | $338.84 | $549.54 | $1,202.26 |
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 $165.96 Median $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $165.96 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $66.07 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 54 · Surgery only | $251.19 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $33.11 | $33.88 | $33.88 |
Where Georgia sits
The same service costs 15.8 times more in Arkansas 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· 40th of 51
$562
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.