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 $741.31 Median $5,370.32 Typical High $10,000.00 | Facility | None | $741.31 | $5,370.32 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $2,511.89 | Professional | None | $741.31 | $741.31 | $2,511.89 |
Ambetter Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
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 $660.69 Median $741.31 Typical High $812.83 | Professional | None | $660.69 | $741.31 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,466.84 Typical High $5,754.40 | Facility | None | $602.56 | $4,466.84 | $5,754.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $851.14 Median $1,202.26 Typical High $3,715.35 | Professional | None | $851.14 | $1,202.26 | $3,715.35 |
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 $707.95 Median $1,148.15 Typical High $2,089.30 | Professional | None | $707.95 | $1,148.15 | $2,089.30 |
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 $371.54 Median $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $371.54 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $151.36 | Professional | 53 · Discontinued | $147.91 | $147.91 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $549.54 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $109.65 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $74.13 |
Where Georgia sits
The same service costs 5.1 times more in Texas than in Delaware. 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· 46th 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.