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 $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $363.08 | Professional | None | $346.74 | $346.74 | $363.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $97.72 Median $309.03 Typical High $1,071.52 | Professional | None | $97.72 | $309.03 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $234.42 Typical High $338.84 | Facility | None | $144.54 | $234.42 | $338.84 |
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 $912.01 | Professional | None | $114.82 | $128.82 | $912.01 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $1,047.13 | Professional | None | $125.89 | $125.89 | $1,047.13 |
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 $173.78 Median $173.78 Typical High $181.97 | Professional | 52 · Reduced service | $173.78 | $173.78 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $69.18 Typical High $72.44 | Professional | 53 · Discontinued | $69.18 | $69.18 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $54.95 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $34.67 Typical High $36.31 | Professional | 56 · Pre-op care only | $34.67 | $34.67 | $36.31 |
Where Georgia sits
The same service costs 5.9 times more in Wyoming 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· 31st of 51
$195
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.