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 $239.88 Median $3,548.13 Typical High $7,585.78 | Facility | None | $239.88 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $239.88 Typical High $281.84 | Professional | None | $69.18 | $239.88 | $281.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $7,943.28 | Facility | None | $7,943.28 | $7,943.28 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $83.18 Median $199.53 Typical High $346.74 | Professional | None | $83.18 | $199.53 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $724.44 Typical High $2,691.53 | Facility | None | $501.19 | $724.44 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $275.42 Typical High $562.34 | Professional | None | $95.50 | $275.42 | $562.34 |
Kaiser Permanente Setting Professional Modifier None Typical Low $74.13 Median $239.88 Typical High $398.11 | Professional | None | $74.13 | $239.88 | $398.11 |
Oscar Health Setting Professional Modifier None Typical Low $125.89 Median $346.74 Typical High $446.68 | Professional | None | $125.89 | $346.74 | $446.68 |
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 $85.11 Median $275.42 Typical High $602.56 | Professional | None | $85.11 | $275.42 | $602.56 |
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 $34.67 Median $56.23 Typical High $134.90 | Professional | 52 · Reduced service | $34.67 | $56.23 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $22.39 Typical High $53.70 | Professional | 53 · Discontinued | $13.80 | $22.39 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $85.11 Typical High $199.53 | Professional | 54 · Surgery only | $51.29 | $85.11 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $16.98 Typical High $39.81 | Professional | 55 · Aftercare only | $10.47 | $16.98 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $11.22 Typical High $26.92 | Professional | 56 · Pre-op care only | $6.92 | $11.22 | $26.92 |
Where Georgia sits
The same service costs 4.5 times more in Oklahoma than in Nebraska. 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· 42nd of 51
$219
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.