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 $371.54 Median $5,623.41 Typical High $10,000.00 | Facility | None | $371.54 | $5,623.41 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $4,466.84 | Professional | None | $371.54 | $371.54 | $4,466.84 |
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 $407.38 Median $478.63 Typical High $537.03 | Professional | None | $407.38 | $478.63 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $8,317.64 Typical High $10,715.19 | Facility | None | $602.56 | $8,317.64 | $10,715.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $537.03 Median $562.34 Typical High $891.25 | Professional | None | $537.03 | $562.34 | $891.25 |
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 $331.13 Median $537.03 Typical High $1,584.89 | Professional | None | $331.13 | $537.03 | $1,584.89 |
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 $186.21 Median $186.21 Typical High $186.21 | Professional | 52 · Reduced service | $186.21 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $75.86 Typical High $75.86 | Professional | 53 · Discontinued | $74.13 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $281.84 Typical High $281.84 | Professional | 54 · Surgery only | $275.42 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $56.23 Typical High $56.23 | Professional | 55 · Aftercare only | $54.95 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $37.15 |
Where Georgia sits
The same service costs 16.2 times more in Arkansas than in West Virginia. 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· 43rd of 51
$562
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.