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 $831.76 Median $5,011.87 Typical High $7,943.28 | Facility | None | $831.76 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $741.31 Typical High $1,000.00 | Professional | None | $208.93 | $741.31 | $1,000.00 |
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 $269.15 Median $691.83 Typical High $2,041.74 | Professional | None | $269.15 | $691.83 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $630.96 Typical High $1,862.09 | Professional | None | $245.47 | $630.96 | $1,862.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $223.87 Median $954.99 Typical High $1,862.09 | Professional | None | $223.87 | $954.99 | $1,862.09 |
Oscar Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
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 $223.87 Median $812.83 Typical High $2,089.30 | Professional | None | $223.87 | $812.83 | $2,089.30 |
6 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 $104.71 Median $316.23 Typical High $489.78 | Professional | 52 · Reduced service | $104.71 | $316.23 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $125.89 Typical High $194.98 | Professional | 53 · Discontinued | $41.69 | $125.89 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $478.63 Typical High $724.44 | Professional | 54 · Surgery only | $158.49 | $478.63 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $95.50 Typical High $144.54 | Professional | 55 · Aftercare only | $31.62 | $95.50 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $63.10 Typical High $97.72 | Professional | 56 · Pre-op care only | $20.89 | $63.10 | $97.72 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 59 · Distinct service | $177.83 | $177.83 | $177.83 |
Where Georgia sits
The same service costs 5.4 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· 37th of 51
$708
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.