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 $288.40 Median $4,466.84 Typical High $7,585.78 | Facility | None | $288.40 | $4,466.84 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $1,288.25 Typical High $3,801.89 | Professional | None | $288.40 | $1,288.25 | $3,801.89 |
Ambetter Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,148.15 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,148.15 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $1,023.29 Typical High $2,951.21 | Professional | None | $331.13 | $1,023.29 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $1,148.15 Typical High $3,311.31 | Professional | None | $302.00 | $1,148.15 | $3,311.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $275.42 Median $1,445.44 Typical High $4,466.84 | Professional | None | $275.42 | $1,445.44 | $4,466.84 |
Oscar Health Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,344.23 | $2,344.23 | $2,344.23 |
United Setting Facility Modifier None Typical Low $2,691.53 Median $7,585.78 Typical High $8,912.51 | Facility | None | $2,691.53 | $7,585.78 | $8,912.51 |
United Setting Professional Modifier None Typical Low $275.42 Median $1,348.96 Typical High $3,467.37 | Professional | None | $275.42 | $1,348.96 | $3,467.37 |
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 $141.25 Median $549.54 Typical High $812.83 | Professional | 52 · Reduced service | $141.25 | $549.54 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $218.78 Typical High $323.59 | Professional | 53 · Discontinued | $56.23 | $218.78 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $812.83 Typical High $1,202.26 | Professional | 54 · Surgery only | $208.93 | $812.83 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $162.18 Typical High $245.47 | Professional | 55 · Aftercare only | $42.66 | $162.18 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $109.65 Typical High $162.18 | Professional | 56 · Pre-op care only | $28.18 | $109.65 | $162.18 |
Where Georgia sits
The same service costs 4.7 times more in Wisconsin than in Nebraska. 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· 31st of 51
$1,230
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.