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 $676.08 Median $5,370.32 Typical High $7,943.28 | Facility | None | $676.08 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $676.08 Typical High $676.08 | Professional | None | $660.69 | $676.08 | $676.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $707.95 Median $1,778.28 Typical High $7,585.78 | Facility | None | $707.95 | $1,778.28 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $691.83 Typical High $2,089.30 | Professional | None | $562.34 | $691.83 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,754.23 Typical High $3,630.78 | Facility | None | $602.56 | $2,754.23 | $3,630.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $269.15 Median $323.59 Typical High $457.09 | Professional | None | $269.15 | $323.59 | $457.09 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $2,884.03 Typical High $8,709.64 | Facility | None | $1,258.93 | $2,884.03 | $8,709.64 |
United Setting Professional Modifier None Typical Low $512.86 Median $794.33 Typical High $1,318.26 | Professional | None | $512.86 | $794.33 | $1,318.26 |
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 $331.13 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $331.13 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $131.83 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $501.19 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $66.07 | $67.61 | $67.61 |
Where Georgia sits
The same service costs 12.6 times more in Ohio than in Nebraska. 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· 30th of 51
$1,202
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.