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 $181.97 Median $5,370.32 Typical High $7,943.28 | Facility | None | $181.97 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $181.97 Typical High $234.42 | Professional | None | $177.83 | $181.97 | $234.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $234.42 Typical High $389.05 | Professional | None | $169.82 | $234.42 | $389.05 |
CareSource Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $288.40 | Professional | None | $269.15 | $269.15 | $288.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $281.84 | Professional | None | $234.42 | $234.42 | $281.84 |
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 $89.13 Median $91.20 Typical High $102.33 | Professional | 52 · Reduced service | $89.13 | $91.20 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $36.31 Typical High $41.69 | Professional | 53 · Discontinued | $35.48 | $36.31 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $134.90 Typical High $154.88 | Professional | 54 · Surgery only | $131.83 | $134.90 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $26.92 Typical High $30.90 | Professional | 55 · Aftercare only | $26.30 | $26.92 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $18.20 Typical High $20.42 | Professional | 56 · Pre-op care only | $17.78 | $18.20 | $20.42 |
Where Georgia sits
The same service costs 25.7 times more in Oklahoma than in Vermont. 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
$229
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.