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 $426.58 Median $5,011.87 Typical High $10,000.00 | Facility | None | $426.58 | $5,011.87 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $426.58 Typical High $4,897.79 | Professional | None | $416.87 | $426.58 | $4,897.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,288.25 Typical High $5,128.61 | Facility | None | $524.81 | $1,288.25 | $5,128.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $354.81 Median $436.52 Typical High $616.60 | Professional | None | $354.81 | $436.52 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,380.38 Typical High $1,995.26 | Facility | None | $602.56 | $1,380.38 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $436.52 Median $446.68 Typical High $707.95 | Professional | None | $436.52 | $446.68 | $707.95 |
United Setting Facility Modifier None Typical Low $501.19 Median $724.44 Typical High $3,548.13 | Facility | None | $501.19 | $724.44 | $3,548.13 |
United Setting Professional Modifier None Typical Low $457.09 Median $724.44 Typical High $1,230.27 | Professional | None | $457.09 | $724.44 | $1,230.27 |
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 $204.17 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $204.17 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $85.11 Typical High $85.11 | Professional | 53 · Discontinued | $81.28 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $316.23 Typical High $316.23 | Professional | 54 · Surgery only | $302.00 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $61.66 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $42.66 Typical High $42.66 | Professional | 56 · Pre-op care only | $40.74 | $42.66 | $42.66 |
Where Georgia sits
The same service costs 8.1 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· 44th of 51
$603
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.