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 $1,479.11 Median $5,011.87 Typical High $10,000.00 | Facility | None | $1,479.11 | $5,011.87 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,479.11 Typical High $1,659.59 | Professional | None | $1,412.54 | $1,479.11 | $1,659.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,348.96 Median $3,090.30 Typical High $15,848.93 | Facility | None | $1,348.96 | $3,090.30 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $2,137.96 Typical High $2,511.89 | Professional | None | $1,380.38 | $2,137.96 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $13,489.63 Typical High $16,982.44 | Facility | None | $660.69 | $13,489.63 | $16,982.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,548.82 Median $2,187.76 Typical High $6,918.31 | Professional | None | $1,548.82 | $2,187.76 | $6,918.31 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $12,882.50 Typical High $25,703.96 | Facility | None | $1,513.56 | $12,882.50 | $25,703.96 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,548.82 Typical High $2,691.53 | Professional | None | $933.25 | $1,548.82 | $2,691.53 |
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 $724.44 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $724.44 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $288.40 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $1,096.48 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $144.54 | $147.91 | $147.91 |
Where Georgia sits
The same service costs 6.9 times more in Arkansas than in Kentucky. 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· 20th of 51
$2,138
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.