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 $83.18 Typical High $87.10 | Facility | None | $44.67 | $83.18 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $74.13 Typical High $89.13 | Professional | None | $44.67 | $74.13 | $89.13 |
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 $38.02 Median $67.61 Typical High $109.65 | Professional | None | $38.02 | $67.61 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $87.10 Typical High $257.04 | Facility | None | $66.07 | $87.10 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $95.50 Typical High $199.53 | Professional | None | $51.29 | $95.50 | $199.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $45.71 Median $109.65 Typical High $162.18 | Professional | None | $45.71 | $109.65 | $162.18 |
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 $45.71 Median $87.10 Typical High $213.80 | Professional | None | $45.71 | $87.10 | $213.80 |
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 $22.39 Median $37.15 Typical High $44.67 | Professional | 52 · Reduced service | $22.39 | $37.15 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $14.79 Typical High $17.78 | Professional | 53 · Discontinued | $8.91 | $14.79 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $10.96 Typical High $13.49 | Professional | 55 · Aftercare only | $6.76 | $10.96 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $7.41 Typical High $8.91 | Professional | 56 · Pre-op care only | $4.47 | $7.41 | $8.91 |
Where Georgia sits
The same service costs 3.9 times more in Alaska than in Virginia. 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· 36th of 51
$75.86
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.