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 $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $173.78 | Professional | None | $128.82 | $128.82 | $173.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $128.82 Median $446.68 Typical High $478.63 | Facility | None | $128.82 | $446.68 | $478.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $104.71 Median $128.82 Typical High $141.25 | Professional | None | $104.71 | $128.82 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $239.88 Typical High $346.74 | Facility | None | $147.91 | $239.88 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $302.00 Typical High $575.44 | Professional | None | $141.25 | $302.00 | $575.44 |
United Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $169.82 | Professional | None | $128.82 | $128.82 | $169.82 |
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 $64.57 Median $64.57 Typical High $74.13 | Professional | 52 · Reduced service | $64.57 | $64.57 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $25.70 Typical High $29.51 | Professional | 53 · Discontinued | $25.70 | $25.70 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.50 Typical High $21.88 | Professional | 55 · Aftercare only | $19.50 | $19.50 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $12.88 Typical High $14.79 | Professional | 56 · Pre-op care only | $12.88 | $12.88 | $14.79 |
Where Georgia sits
The same service costs 1.6 times more in Texas than in North Carolina. 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· 36th of 51
$129
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.