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 $4,466.84 Median $6,606.93 Typical High $10,000.00 | Facility | None | $4,466.84 | $6,606.93 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $5,754.40 Median $6,606.93 Typical High $6,606.93 | Professional | None | $5,754.40 | $6,606.93 | $6,606.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $2,691.53 Typical High $12,022.64 | Facility | None | $1,096.48 | $2,691.53 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $11,220.18 Median $14,791.08 Typical High $15,848.93 | Professional | None | $11,220.18 | $14,791.08 | $15,848.93 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $9,549.93 Typical High $12,022.64 | Facility | None | $602.56 | $9,549.93 | $12,022.64 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,981.07 Median $4,168.69 Typical High $6,606.93 | Professional | None | $3,981.07 | $4,168.69 | $6,606.93 |
Oscar Health Setting Professional Modifier None Typical Low $43,651.58 Median $50,118.72 Typical High $58,884.37 | Professional | None | $43,651.58 | $50,118.72 | $58,884.37 |
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 $2,818.38 Median $15,135.61 Typical High $30,902.95 | Professional | None | $2,818.38 | $15,135.61 | $30,902.95 |
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 $3,090.30 Median $3,311.31 Typical High $3,311.31 | Professional | 52 · Reduced service | $3,090.30 | $3,311.31 | $3,311.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,258.93 Median $1,318.26 Typical High $1,318.26 | Professional | 53 · Discontinued | $1,258.93 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4,677.35 Median $4,897.79 Typical High $4,897.79 | Professional | 54 · Surgery only | $4,677.35 | $4,897.79 | $4,897.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $933.25 Median $977.24 Typical High $977.24 | Professional | 55 · Aftercare only | $933.25 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $630.96 Median $660.69 Typical High $660.69 | Professional | 56 · Pre-op care only | $630.96 | $660.69 | $660.69 |
Where Georgia sits
The same service costs 16.6 times more in Indiana 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· 18th of 51
$11,482
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.