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 $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $467.74 | Professional | None | $446.68 | $446.68 | $467.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $97.72 Median $446.68 Typical High $1,479.11 | Professional | None | $97.72 | $446.68 | $1,479.11 |
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 $1,698.24 | Professional | None | $114.82 | $128.82 | $1,698.24 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $1,445.44 | Professional | None | $125.89 | $125.89 | $1,445.44 |
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 $223.87 Median $223.87 Typical High $234.42 | Professional | 52 · Reduced service | $223.87 | $223.87 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $89.13 Typical High $93.33 | Professional | 53 · Discontinued | $89.13 | $89.13 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $70.79 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $46.77 | Professional | 56 · Pre-op care only | $44.67 | $44.67 | $46.77 |
Where Georgia sits
The same service costs 10.0 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· 27th of 51
$219
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.