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 $575.44 Median $5,623.41 Typical High $10,000.00 | Facility | None | $575.44 | $5,623.41 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $575.44 Typical High $4,466.84 | Professional | None | $562.34 | $575.44 | $4,466.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,513.56 Typical High $6,309.57 | Facility | None | $588.84 | $1,513.56 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $524.81 Typical High $588.84 | Professional | None | $60.26 | $524.81 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,754.40 Typical High $7,413.10 | Facility | None | $602.56 | $5,754.40 | $7,413.10 |
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 $354.81 Median $602.56 Typical High $2,137.96 | Professional | None | $354.81 | $602.56 | $2,137.96 |
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 $281.84 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $281.84 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $426.58 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $85.11 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $56.23 | $57.54 | $57.54 |
Where Georgia sits
The same service costs 14.8 times more in Texas than in Maine. 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· 45th of 51
$589
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.