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 $363.08 Median $3,548.13 Typical High $7,585.78 | Facility | None | $363.08 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $323.59 Typical High $398.11 | Professional | None | $83.18 | $323.59 | $398.11 |
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 $100.00 Median $288.40 Typical High $660.69 | Professional | None | $100.00 | $288.40 | $660.69 |
CareSource Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $181.97 Typical High $831.76 | Facility | None | $138.04 | $181.97 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $269.15 Typical High $851.14 | Professional | None | $95.50 | $269.15 | $851.14 |
Kaiser Permanente Setting Professional Modifier None Typical Low $97.72 Median $436.52 Typical High $2,344.23 | Professional | None | $97.72 | $436.52 | $2,344.23 |
Oscar Health Setting Professional Modifier None Typical Low $95.50 Median $338.84 Typical High $758.58 | Professional | None | $95.50 | $338.84 | $758.58 |
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 $87.10 Median $302.00 Typical High $812.83 | Professional | None | $87.10 | $302.00 | $812.83 |
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 $41.69 Median $131.83 Typical High $194.98 | Professional | 52 · Reduced service | $41.69 | $131.83 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $52.48 Typical High $77.62 | Professional | 53 · Discontinued | $16.60 | $52.48 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $194.98 Typical High $295.12 | Professional | 54 · Surgery only | $63.10 | $194.98 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $38.90 Typical High $58.88 | Professional | 55 · Aftercare only | $12.59 | $38.90 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $26.30 Typical High $38.90 | Professional | 56 · Pre-op care only | $8.32 | $26.30 | $38.90 |
Where Georgia sits
The same service costs 4.8 times more in Wisconsin than in Washington, DC. 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· 28th of 51
$288
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.