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 $1,348.96 Median $6,025.60 Typical High $13,803.84 | Facility | None | $1,348.96 | $6,025.60 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $5,888.44 | Professional | None | $501.19 | $501.19 | $5,888.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,548.82 Typical High $6,309.57 | Facility | None | $588.84 | $1,548.82 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $812.83 | Professional | None | $416.87 | $524.81 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,511.89 Typical High $3,311.31 | Facility | None | $602.56 | $2,511.89 | $3,311.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,000.00 Median $1,047.13 Typical High $1,659.59 | Professional | None | $1,000.00 | $1,047.13 | $1,659.59 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $7,585.78 | Facility | None | $954.99 | $1,995.26 | $7,585.78 |
United Setting Professional Modifier None Typical Low $549.54 Median $870.96 Typical High $1,995.26 | Professional | None | $549.54 | $870.96 | $1,995.26 |
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 $251.19 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $251.19 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $380.19 Typical High $380.19 | Professional | 54 · Surgery only | $371.54 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $74.13 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $50.12 |
Where Georgia sits
The same service costs 10.2 times more in Texas than in New York. 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· 42nd of 51
$813
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.