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 $489.78 Median $5,623.41 Typical High $10,000.00 | Facility | None | $489.78 | $5,623.41 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $489.78 Typical High $4,466.84 | Professional | None | $478.63 | $489.78 | $4,466.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,348.96 Median $3,090.30 Typical High $15,848.93 | Facility | None | $1,348.96 | $3,090.30 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $436.52 Median $776.25 Typical High $870.96 | Professional | None | $436.52 | $776.25 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $8,709.64 Typical High $10,964.78 | Facility | None | $602.56 | $8,709.64 | $10,964.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $588.84 Median $602.56 Typical High $954.99 | Professional | None | $588.84 | $602.56 | $954.99 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $16,218.10 Typical High $35,481.34 | Facility | None | $1,513.56 | $16,218.10 | $35,481.34 |
United Setting Professional Modifier None Typical Low $537.03 Median $851.14 Typical High $1,584.89 | Professional | None | $537.03 | $851.14 | $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 $239.88 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $239.88 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $97.72 Typical High $97.72 | Professional | 53 · Discontinued | $95.50 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | 54 · Surgery only | $363.08 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $72.44 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $48.98 Typical High $48.98 | Professional | 56 · Pre-op care only | $47.86 | $48.98 | $48.98 |
Where Georgia sits
The same service costs 24.0 times more in Arkansas 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· 39th of 51
$871
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.