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 $162.18 Median $3,548.13 Typical High $7,585.78 | Facility | None | $162.18 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $147.91 Typical High $181.97 | Professional | None | $60.26 | $147.91 | $181.97 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $7,943.28 | Facility | None | $7,943.28 | $7,943.28 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $79.43 Median $186.21 Typical High $407.38 | Professional | None | $79.43 | $186.21 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $158.49 Typical High $398.11 | Professional | None | $69.18 | $158.49 | $398.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $63.10 Median $177.83 Typical High $758.58 | Professional | None | $63.10 | $177.83 | $758.58 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,778.28 Typical High $2,818.38 | Facility | None | $691.83 | $1,778.28 | $2,818.38 |
United Setting Professional Modifier None Typical Low $66.07 Median $158.49 Typical High $416.87 | Professional | None | $66.07 | $158.49 | $416.87 |
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 $30.20 Median $70.79 Typical High $89.13 | Professional | 52 · Reduced service | $30.20 | $70.79 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $28.18 Typical High $35.48 | Professional | 53 · Discontinued | $12.02 | $28.18 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $107.15 Typical High $134.90 | Professional | 54 · Surgery only | $45.71 | $107.15 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $21.38 Typical High $26.92 | Professional | 55 · Aftercare only | $9.12 | $21.38 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $14.13 Typical High $17.78 | Professional | 56 · Pre-op care only | $6.03 | $14.13 | $17.78 |
Where Georgia sits
The same service costs 3.7 times more in Wisconsin than in Maryland. 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· 17th of 51
$162
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.