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 $2,187.76 Median $4,365.16 Typical High $10,000.00 | Facility | None | $2,187.76 | $4,365.16 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $125.89 Typical High $1,230.27 | Professional | None | $18.62 | $125.89 | $1,230.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $398.11 Median $912.01 Typical High $3,801.89 | Facility | None | $398.11 | $912.01 | $3,801.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $151.36 Typical High $165.96 | Professional | None | $134.90 | $151.36 | $165.96 |
United Setting Facility Modifier None Typical Low $79.43 Median $158.49 Typical High $1,778.28 | Facility | None | $79.43 | $158.49 | $1,778.28 |
United Setting Professional Modifier None Typical Low $20.89 Median $37.15 Typical High $64.57 | Professional | None | $20.89 | $37.15 | $64.57 |
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 $9.33 Median $10.47 Typical High $63.10 | Professional | 52 · Reduced service | $9.33 | $10.47 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $4.17 Typical High $25.12 | Professional | 53 · Discontinued | $3.72 | $4.17 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $14.13 Median $15.85 Typical High $95.50 | Professional | 54 · Surgery only | $14.13 | $15.85 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $3.16 Typical High $19.05 | Professional | 55 · Aftercare only | $2.82 | $3.16 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $2.09 Typical High $12.59 | Professional | 56 · Pre-op care only | $1.86 | $2.09 | $12.59 |
Where Georgia sits
The same service costs 14.5 times more in New Hampshire than in New Jersey. 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· 7th of 51
$151
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.