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 $234.42 Median $4,466.84 Typical High $7,585.78 | Facility | None | $234.42 | $4,466.84 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $234.42 Typical High $257.04 | Professional | None | $138.04 | $234.42 | $257.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,071.52 Typical High $5,754.40 | Facility | None | $512.86 | $1,071.52 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $141.25 Median $229.09 Typical High $371.54 | Professional | None | $141.25 | $229.09 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,949.84 Typical High $2,454.71 | Facility | None | $524.81 | $1,949.84 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $245.47 Typical High $512.86 | Professional | None | $141.25 | $245.47 | $512.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $125.89 Median $229.09 Typical High $416.87 | Professional | None | $125.89 | $229.09 | $416.87 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,479.11 Typical High $5,011.87 | Facility | None | $851.14 | $1,479.11 | $5,011.87 |
United Setting Professional Modifier None Typical Low $134.90 Median $251.19 Typical High $524.81 | Professional | None | $134.90 | $251.19 | $524.81 |
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 $69.18 Median $109.65 Typical High $128.82 | Professional | 52 · Reduced service | $69.18 | $109.65 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $43.65 Typical High $51.29 | Professional | 53 · Discontinued | $27.54 | $43.65 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $165.96 Typical High $190.55 | Professional | 54 · Surgery only | $104.71 | $165.96 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $33.11 Typical High $38.90 | Professional | 55 · Aftercare only | $20.89 | $33.11 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $21.88 Typical High $25.70 | Professional | 56 · Pre-op care only | $13.80 | $21.88 | $25.70 |
Where Georgia sits
The same service costs 3.7 times more in Alaska 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· 22nd of 51
$275
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.