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 $38.90 Median $3,548.13 Typical High $7,585.78 | Facility | None | $38.90 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $154.88 Typical High $288.40 | Professional | None | $36.31 | $154.88 | $288.40 |
Ambetter Setting Professional Modifier None Typical Low $43.65 Median $63.10 Typical High $323.59 | Professional | None | $43.65 | $63.10 | $323.59 |
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 $47.86 Median $120.23 Typical High $302.00 | Professional | None | $47.86 | $120.23 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $123.03 Typical High $398.11 | Professional | None | $43.65 | $123.03 | $398.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $38.90 Median $204.17 Typical High $346.74 | Professional | None | $38.90 | $204.17 | $346.74 |
Oscar Health Setting Professional Modifier None Typical Low $35.48 Median $158.49 Typical High $346.74 | Professional | None | $35.48 | $158.49 | $346.74 |
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 $39.81 Median $147.91 Typical High $416.87 | Professional | None | $39.81 | $147.91 | $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 $18.20 Median $79.43 Typical High $102.33 | Professional | 52 · Reduced service | $18.20 | $79.43 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $31.62 Typical High $40.74 | Professional | 53 · Discontinued | $7.41 | $31.62 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $27.54 Median $120.23 Typical High $151.36 | Professional | 54 · Surgery only | $27.54 | $120.23 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $23.99 Typical High $30.90 | Professional | 55 · Aftercare only | $5.50 | $23.99 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $15.85 Typical High $20.42 | Professional | 56 · Pre-op care only | $3.63 | $15.85 | $20.42 |
Where Georgia sits
The same service costs 4.5 times more in Wisconsin than in Michigan. 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· 39th of 51
$123
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.