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 $44.67 Median $44.67 Typical High $44.67 | Facility | None | $44.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.76 Median $125.89 Typical High $3,981.07 | Professional | None | $6.76 | $125.89 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $158.49 Typical High $257.04 | Facility | None | $125.89 | $158.49 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $144.54 | Professional | None | $125.89 | $125.89 | $144.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $114.82 Median $128.82 Typical High $154.88 | Professional | None | $114.82 | $128.82 | $154.88 |
Oscar Health Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $239.88 | Professional | None | $194.98 | $194.98 | $239.88 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $3,890.45 | Professional | None | $125.89 | $125.89 | $3,890.45 |
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 $21.88 Median $21.88 Typical High $21.88 | Professional | 52 · Reduced service | $21.88 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | 53 · Discontinued | $8.91 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | 54 · Surgery only | $33.11 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | 55 · Aftercare only | $6.61 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | 56 · Pre-op care only | $4.47 | $4.47 | $4.47 |
Where Georgia sits
The same service costs 6.3 times more in North Dakota than in Hawaii. 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· 8th of 51
$126
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.