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 $128.82 Median $5,370.32 Typical High $7,943.28 | Facility | None | $128.82 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $141.25 Typical High $346.74 | Professional | None | $128.82 | $141.25 | $346.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,258.93 Typical High $5,128.61 | Facility | None | $524.81 | $1,258.93 | $5,128.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $181.97 Typical High $316.23 | Professional | None | $117.49 | $181.97 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $831.76 Typical High $4,265.80 | Facility | None | $512.86 | $831.76 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $218.78 Typical High $389.05 | Professional | None | $151.36 | $218.78 | $389.05 |
Kaiser Permanente Setting Professional Modifier None Typical Low $120.23 Median $154.88 Typical High $512.86 | Professional | None | $120.23 | $154.88 | $512.86 |
United Setting Facility Modifier None Typical Low $371.54 Median $645.65 Typical High $3,981.07 | Facility | None | $371.54 | $645.65 | $3,981.07 |
United Setting Professional Modifier None Typical Low $128.82 Median $190.55 Typical High $389.05 | Professional | None | $128.82 | $190.55 | $389.05 |
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 $64.57 Median $64.57 Typical High $75.86 | Professional | 52 · Reduced service | $64.57 | $64.57 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $25.70 Typical High $30.20 | Professional | 53 · Discontinued | $25.70 | $25.70 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $95.50 Typical High $112.20 | Professional | 54 · Surgery only | $95.50 | $95.50 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.05 Typical High $22.39 | Professional | 55 · Aftercare only | $19.05 | $19.05 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $12.88 Typical High $15.14 | Professional | 56 · Pre-op care only | $12.88 | $12.88 | $15.14 |
Where Georgia sits
The same service costs 3.9 times more in Alaska than in Utah. 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· 14th of 51
$224
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.