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 $38.02 Median $5,370.32 Typical High $7,585.78 | Facility | None | $38.02 | $5,370.32 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $64.57 Typical High $154.88 | Professional | None | $38.02 | $64.57 | $154.88 |
Ambetter Setting Professional Modifier None Typical Low $74.13 Median $125.89 Typical High $128.82 | Professional | None | $74.13 | $125.89 | $128.82 |
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 $52.48 Median $85.11 Typical High $165.96 | Professional | None | $52.48 | $85.11 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $47.86 Typical High $128.82 | Facility | None | $36.31 | $47.86 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $89.13 Typical High $173.78 | Professional | None | $47.86 | $89.13 | $173.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $45.71 Median $79.43 Typical High $117.49 | Professional | None | $45.71 | $79.43 | $117.49 |
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 $48.98 Median $89.13 Typical High $162.18 | Professional | None | $48.98 | $89.13 | $162.18 |
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 $19.05 Median $29.51 Typical High $38.90 | Professional | 52 · Reduced service | $19.05 | $29.51 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $11.75 Typical High $15.85 | Professional | 53 · Discontinued | $7.59 | $11.75 | $15.85 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.18 Median $44.67 Typical High $58.88 | Professional | 54 · Surgery only | $28.18 | $44.67 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $8.91 Typical High $11.75 | Professional | 55 · Aftercare only | $5.62 | $8.91 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $5.89 Typical High $7.76 | Professional | 56 · Pre-op care only | $3.80 | $5.89 | $7.76 |
Where Georgia sits
The same service costs 3.1 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· 19th of 51
$89.13
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.