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 $67.61 Median $5,370.32 Typical High $7,943.28 | Facility | None | $67.61 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $85.11 | Professional | None | $67.61 | $67.61 | $85.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $380.19 Median $776.25 Typical High $3,630.78 | Facility | None | $380.19 | $776.25 | $3,630.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $64.57 Median $83.18 Typical High $165.96 | Professional | None | $64.57 | $83.18 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $489.78 Typical High $660.69 | Facility | None | $346.74 | $489.78 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $147.91 Typical High $169.82 | Professional | None | $63.10 | $147.91 | $169.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $85.11 Median $91.20 Typical High $114.82 | Professional | None | $85.11 | $91.20 | $114.82 |
Oscar Health Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $114.82 | Professional | None | $100.00 | $100.00 | $114.82 |
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 $74.13 Median $120.23 Typical High $204.17 | Professional | None | $74.13 | $120.23 | $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 $33.11 Median $33.11 Typical High $40.74 | Professional | 52 · Reduced service | $33.11 | $33.11 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $16.22 | Professional | 53 · Discontinued | $13.49 | $13.49 | $16.22 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $50.12 Typical High $61.66 | Professional | 54 · Surgery only | $50.12 | $50.12 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $12.30 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.61 Typical High $8.13 | Professional | 56 · Pre-op care only | $6.61 | $6.61 | $8.13 |
Where Georgia sits
The same service costs 5.5 times more in Arkansas than in Kentucky. 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· 34th of 51
$93.33
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.