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 $77.62 Median $77.62 Typical High $85.11 | Facility | None | $77.62 | $77.62 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $81.28 Typical High $204.17 | Professional | None | $77.62 | $81.28 | $204.17 |
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 $20.89 Median $47.86 Typical High $154.88 | Professional | None | $20.89 | $47.86 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $204.17 | Facility | None | $91.20 | $91.20 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $128.82 Typical High $177.83 | Professional | None | $24.55 | $128.82 | $177.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $177.83 | Professional | None | $20.89 | $20.89 | $177.83 |
United Setting Professional Modifier None Typical Low $36.31 Median $85.11 Typical High $147.91 | Professional | None | $36.31 | $85.11 | $147.91 |
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 $38.90 Median $38.90 Typical High $42.66 | Professional | 52 · Reduced service | $38.90 | $38.90 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $15.49 Typical High $17.38 | Professional | 53 · Discontinued | $15.49 | $15.49 | $17.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $57.54 Typical High $64.57 | Professional | 54 · Surgery only | $57.54 | $57.54 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $11.48 Typical High $12.88 | Professional | 55 · Aftercare only | $11.48 | $11.48 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.76 Typical High $8.51 | Professional | 56 · Pre-op care only | $7.76 | $7.76 | $8.51 |
Where Georgia sits
The same service costs 4.5 times more in Alaska than in Ohio. 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· 38th of 51
$58.88
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.