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 $44.67 Median $5,370.32 Typical High $7,585.78 | Facility | None | $44.67 | $5,370.32 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $69.18 Typical High $83.18 | Professional | None | $44.67 | $69.18 | $83.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $478.63 Median $851.14 Typical High $3,630.78 | Facility | None | $478.63 | $851.14 | $3,630.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $52.48 Median $81.28 Typical High $144.54 | Professional | None | $52.48 | $81.28 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $67.61 Typical High $199.53 | Facility | None | $54.95 | $67.61 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $100.00 Typical High $177.83 | Professional | None | $42.66 | $100.00 | $177.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $50.12 Median $100.00 Typical High $223.87 | Professional | None | $50.12 | $100.00 | $223.87 |
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 $54.95 Median $97.72 Typical High $204.17 | Professional | None | $54.95 | $97.72 | $204.17 |
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 $22.39 Median $33.88 Typical High $41.69 | Professional | 52 · Reduced service | $22.39 | $33.88 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $13.49 Typical High $16.60 | Professional | 53 · Discontinued | $8.91 | $13.49 | $16.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $50.12 Typical High $61.66 | Professional | 54 · Surgery only | $33.88 | $50.12 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $10.00 Typical High $12.30 | Professional | 55 · Aftercare only | $6.76 | $10.00 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $6.76 Typical High $8.32 | Professional | 56 · Pre-op care only | $4.47 | $6.76 | $8.32 |
Where Georgia sits
The same service costs 3.4 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· 19th of 51
$87.10
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.