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 $354.81 Median $5,011.87 Typical High $7,943.28 | Facility | None | $354.81 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $295.12 | Professional | None | $186.21 | $186.21 | $295.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $467.74 Median $707.95 Typical High $1,737.80 | Facility | None | $467.74 | $707.95 | $1,737.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $177.83 Median $257.04 Typical High $416.87 | Professional | None | $177.83 | $257.04 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $616.60 Typical High $3,235.94 | Facility | None | $446.68 | $616.60 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $309.03 Typical High $537.03 | Professional | None | $213.80 | $309.03 | $537.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $177.83 Median $208.93 Typical High $446.68 | Professional | None | $177.83 | $208.93 | $446.68 |
Oscar Health Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
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 $162.18 Median $275.42 Typical High $501.19 | Professional | None | $162.18 | $275.42 | $501.19 |
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 $93.33 Median $93.33 Typical High $109.65 | Professional | 52 · Reduced service | $93.33 | $93.33 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $43.65 | Professional | 53 · Discontinued | $37.15 | $37.15 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $138.04 Typical High $162.18 | Professional | 54 · Surgery only | $138.04 | $138.04 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $32.36 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $21.88 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $21.88 |
Where Georgia sits
The same service costs 4.5 times more in Alaska 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· 21st of 51
$257
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.