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 $239.88 Median $5,623.41 Typical High $9,549.93 | Facility | None | $239.88 | $5,623.41 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $128.82 Typical High $363.08 | Professional | None | $120.23 | $128.82 | $363.08 |
Ambetter Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $251.19 | Professional | None | $234.42 | $234.42 | $251.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,288.25 Typical High $4,570.88 | Facility | None | $724.44 | $1,288.25 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $123.03 Median $186.21 Typical High $323.59 | Professional | None | $123.03 | $186.21 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $1,995.26 Typical High $2,754.23 | Facility | None | $812.83 | $1,995.26 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $204.17 Typical High $346.74 | Professional | None | $131.83 | $204.17 | $346.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $125.89 Median $158.49 Typical High $309.03 | Professional | None | $125.89 | $158.49 | $309.03 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $7,585.78 | Facility | None | $954.99 | $1,995.26 | $7,585.78 |
United Setting Professional Modifier None Typical Low $138.04 Median $213.80 Typical High $323.59 | Professional | None | $138.04 | $213.80 | $323.59 |
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 $56.23 Median $58.88 Typical High $72.44 | Professional | 52 · Reduced service | $56.23 | $58.88 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $23.99 Typical High $28.84 | Professional | 53 · Discontinued | $22.39 | $23.99 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $89.13 Typical High $107.15 | Professional | 54 · Surgery only | $83.18 | $89.13 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $17.78 Typical High $21.38 | Professional | 55 · Aftercare only | $16.98 | $17.78 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $12.02 Typical High $14.45 | Professional | 56 · Pre-op care only | $11.22 | $12.02 | $14.45 |
Where Georgia sits
The same service costs 10.7 times more in Oklahoma 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· 27th of 51
$209
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.