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 $549.54 Median $5,370.32 Typical High $10,000.00 | Facility | None | $549.54 | $5,370.32 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $5,370.32 | Professional | None | $549.54 | $549.54 | $5,370.32 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,513.56 Typical High $6,309.57 | Facility | None | $588.84 | $1,513.56 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $89.13 Median $489.78 Typical High $691.83 | Professional | None | $89.13 | $489.78 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,511.89 Typical High $3,162.28 | Facility | None | $602.56 | $2,511.89 | $3,162.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $436.52 Typical High $691.83 | Professional | None | $416.87 | $436.52 | $691.83 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $7,585.78 | Facility | None | $954.99 | $1,995.26 | $7,585.78 |
United Setting Professional Modifier None Typical Low $575.44 Median $870.96 Typical High $1,288.25 | Professional | None | $575.44 | $870.96 | $1,288.25 |
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 $263.03 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $263.03 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $104.71 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $416.87 Typical High $416.87 | Professional | 54 · Surgery only | $398.11 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $79.43 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $52.48 | $54.95 | $54.95 |
Where Georgia sits
The same service costs 10.2 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· 44th of 51
$741
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.