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 $199.53 Median $3,548.13 Typical High $7,585.78 | Facility | None | $199.53 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $85.11 Typical High $199.53 | Professional | None | $75.86 | $85.11 | $199.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $1,000.00 Typical High $5,754.40 | Facility | None | $389.05 | $1,000.00 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $66.07 Median $104.71 Typical High $223.87 | Professional | None | $66.07 | $104.71 | $223.87 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $114.82 Median $162.18 Typical High $338.84 | Professional | 50 · Both sides | $114.82 | $162.18 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $1,445.44 Typical High $1,778.28 | Facility | None | $398.11 | $1,445.44 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $120.23 Typical High $208.93 | Professional | None | $85.11 | $120.23 | $208.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $69.18 Median $85.11 Typical High $257.04 | Professional | None | $69.18 | $85.11 | $257.04 |
United Setting Facility Modifier None Typical Low $501.19 Median $724.44 Typical High $3,548.13 | Facility | None | $501.19 | $724.44 | $3,548.13 |
United Setting Professional Modifier None Typical Low $77.62 Median $114.82 Typical High $208.93 | Professional | None | $77.62 | $114.82 | $208.93 |
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 $38.02 Median $38.02 Typical High $48.98 | Professional | 52 · Reduced service | $38.02 | $38.02 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $19.50 | Professional | 53 · Discontinued | $15.14 | $15.14 | $19.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $57.54 Typical High $74.13 | Professional | 54 · Surgery only | $57.54 | $57.54 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $11.48 Typical High $14.79 | Professional | 55 · Aftercare only | $11.48 | $11.48 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $9.77 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $9.77 |
Where Georgia sits
The same service costs 11.2 times more in Tennessee than in New York. 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· 24th of 51
$126
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.