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 $223.87 Median $5,370.32 Typical High $10,000.00 | Facility | None | $223.87 | $5,370.32 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $257.04 | Professional | None | $223.87 | $223.87 | $257.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $912.01 Median $1,698.24 Typical High $9,772.37 | Facility | None | $912.01 | $1,698.24 | $9,772.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $288.40 Typical High $446.68 | Professional | None | $204.17 | $288.40 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $4,073.80 Typical High $5,495.41 | Facility | None | $660.69 | $4,073.80 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $346.74 Typical High $512.86 | Professional | None | $223.87 | $346.74 | $512.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $181.97 Median $218.78 Typical High $1,318.26 | Professional | None | $181.97 | $218.78 | $1,318.26 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $7,585.78 | Facility | None | $954.99 | $1,995.26 | $7,585.78 |
United Setting Professional Modifier None Typical Low $213.80 Median $354.81 Typical High $562.34 | Professional | None | $213.80 | $354.81 | $562.34 |
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 $112.20 Median $112.20 Typical High $128.82 | Professional | 52 · Reduced service | $112.20 | $112.20 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $44.67 Typical High $51.29 | Professional | 53 · Discontinued | $44.67 | $44.67 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $169.82 Typical High $194.98 | Professional | 54 · Surgery only | $169.82 | $169.82 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $38.90 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.39 Typical High $25.70 | Professional | 56 · Pre-op care only | $22.39 | $22.39 | $25.70 |
Where Georgia sits
The same service costs 6.9 times more in Tennessee 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· 25th of 51
$355
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.