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 $1,778.28 Median $6,606.93 Typical High $13,803.84 | Facility | None | $1,778.28 | $6,606.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $5,754.40 | Professional | None | $47.86 | $47.86 | $5,754.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $12,022.64 | Facility | None | $1,122.02 | $2,754.23 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $42.66 Median $83.18 Typical High $389.05 | Professional | None | $42.66 | $83.18 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $7,943.28 Typical High $10,000.00 | Facility | None | $602.56 | $7,943.28 | $10,000.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $467.74 Median $489.78 Typical High $776.25 | Professional | None | $467.74 | $489.78 | $776.25 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $6,760.83 Typical High $12,882.50 | Facility | None | $1,513.56 | $6,760.83 | $12,882.50 |
United Setting Professional Modifier None Typical Low $52.48 Median $89.13 Typical High $1,258.93 | Professional | None | $52.48 | $89.13 | $1,258.93 |
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 $23.99 Median $23.99 Typical High $25.70 | Professional | 52 · Reduced service | $23.99 | $23.99 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $9.77 Typical High $10.23 | Professional | 53 · Discontinued | $9.55 | $9.77 | $10.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $36.31 Typical High $38.90 | Professional | 54 · Surgery only | $35.48 | $36.31 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.24 Typical High $7.76 | Professional | 55 · Aftercare only | $7.08 | $7.24 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $4.79 Typical High $5.13 | Professional | 56 · Pre-op care only | $4.79 | $4.79 | $5.13 |
Where Georgia sits
The same service costs 93.3 times more in Oregon than in Vermont. 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· 32nd of 51
$646
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.