How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $77.62 Median $81.28 Typical High $81.28 | Facility | None | $77.62 | $81.28 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $81.28 Typical High $81.28 | Professional | None | $77.62 | $81.28 | $81.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $58.88 Median $69.18 Typical High $81.28 | Professional | None | $58.88 | $69.18 | $81.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $93.33 Median $102.33 Typical High $158.49 | Professional | None | $93.33 | $102.33 | $158.49 |
United Setting Professional Modifier None Typical Low $87.10 Median $131.83 Typical High $245.47 | Professional | None | $87.10 | $131.83 | $245.47 |
4 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 $38.90 Median $40.74 Typical High $40.74 | Professional | 52 · Reduced service | $38.90 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $16.22 Typical High $16.22 | Professional | 53 · Discontinued | $15.49 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $12.02 Typical High $12.02 | Professional | 55 · Aftercare only | $11.75 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $8.13 Typical High $8.13 | Professional | 56 · Pre-op care only | $7.76 | $8.13 | $8.13 |
Where Georgia sits
The same service costs 3.2 times more in Alaska 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· 50th of 51
$69.18
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.