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 $288.40 Median $288.40 Typical High $288.40 | Facility | None | $288.40 | $288.40 | $288.40 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $275.42 Median $323.59 Typical High $1,412.54 | Facility | None | $275.42 | $323.59 | $1,412.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $229.09 Median $288.40 Typical High $338.84 | Professional | None | $229.09 | $288.40 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $354.81 Typical High $562.34 | Facility | None | $316.23 | $354.81 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $275.42 Median $812.83 Typical High $1,096.48 | Professional | None | $275.42 | $812.83 | $1,096.48 |
United Setting Professional Modifier None Typical Low $275.42 Median $338.84 Typical High $660.69 | Professional | None | $275.42 | $338.84 | $660.69 |
4 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 $144.54 Median $144.54 Typical High $144.54 | Professional | 52 · Reduced service | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | 53 · Discontinued | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | 55 · Aftercare only | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | 56 · Pre-op care only | $28.84 | $28.84 | $28.84 |
Where Georgia sits
The same service costs 10.0 times more in Arizona than in Alabama. 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· 35th of 51
$288
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.