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 $562.34 Median $562.34 Typical High $562.34 | Facility | None | $562.34 | $562.34 | $562.34 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $1,096.48 | Professional | None | $562.34 | $562.34 | $1,096.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $2,290.87 Typical High $2,398.83 | Facility | None | $660.69 | $2,290.87 | $2,398.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $478.63 Median $562.34 Typical High $1,047.13 | Professional | None | $478.63 | $562.34 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,047.13 Typical High $1,513.56 | Facility | None | $645.65 | $1,047.13 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
Kaiser Permanente Setting Professional Modifier None Typical Low $616.60 Median $2,511.89 Typical High $2,630.27 | Professional | None | $616.60 | $2,511.89 | $2,630.27 |
United Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,148.15 | Professional | None | $660.69 | $660.69 | $1,148.15 |
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 $281.84 Median $281.84 Typical High $446.68 | Professional | 52 · Reduced service | $281.84 | $281.84 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $177.83 | Professional | 53 · Discontinued | $112.20 | $112.20 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $131.83 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $89.13 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $89.13 |
Where Georgia sits
The same service costs 2.7 times more in Wyoming 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
$562
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.