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 $75.86 Median $75.86 Typical High $204.17 | Facility | None | $75.86 | $75.86 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $100.00 Typical High $199.53 | Professional | None | $75.86 | $100.00 | $199.53 |
Ambetter Setting Professional Modifier None Typical Low $57.54 Median $60.26 Typical High $158.49 | Professional | None | $57.54 | $60.26 | $158.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $29.51 Median $125.89 Typical High $398.11 | Facility | None | $29.51 | $125.89 | $398.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.95 Median $33.11 Typical High $100.00 | Professional | None | $19.95 | $33.11 | $100.00 |
CareSource Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
CareSource Setting Professional Modifier None Typical Low $74.13 Median $114.82 Typical High $114.82 | Professional | None | $74.13 | $114.82 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $251.19 Typical High $346.74 | Facility | None | $147.91 | $251.19 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $147.91 | Professional | None | $60.26 | $60.26 | $147.91 |
Kaiser Permanente Setting Professional Modifier None Typical Low $114.82 Median $117.49 Typical High $125.89 | Professional | None | $114.82 | $117.49 | $125.89 |
United Setting Professional Modifier None Typical Low $12.88 Median $63.10 Typical High $239.88 | Professional | None | $12.88 | $63.10 | $239.88 |
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 $38.02 Median $44.67 Typical High $54.95 | Professional | 52 · Reduced service | $38.02 | $44.67 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $17.78 Typical High $21.88 | Professional | 53 · Discontinued | $15.14 | $17.78 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $67.61 Typical High $83.18 | Professional | 54 · Surgery only | $57.54 | $67.61 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $13.49 Typical High $16.60 | Professional | 55 · Aftercare only | $11.48 | $13.49 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $8.91 Typical High $10.96 | Professional | 56 · Pre-op care only | $7.59 | $8.91 | $10.96 |
Where Georgia sits
The same service costs 4.9 times more in Alaska than in Georgia. 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· 51st of 51
$45.71
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.