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 $588.84 Median $7,413.10 Typical High $12,302.69 | Facility | None | $588.84 | $7,413.10 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $588.84 Typical High $5,370.32 | Professional | None | $575.44 | $588.84 | $5,370.32 |
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 $446.68 Median $602.56 Typical High $741.31 | Professional | None | $446.68 | $602.56 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $16,218.10 Typical High $20,892.96 | Facility | None | $602.56 | $16,218.10 | $20,892.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $537.03 Median $549.54 Typical High $870.96 | Professional | None | $537.03 | $549.54 | $870.96 |
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 $645.65 Median $977.24 Typical High $1,621.81 | Professional | None | $645.65 | $977.24 | $1,621.81 |
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 $295.12 | Professional | 52 · Reduced service | $281.84 | $288.40 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $117.49 Typical High $117.49 | Professional | 53 · Discontinued | $112.20 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $446.68 Typical High $446.68 | Professional | 54 · Surgery only | $416.87 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $87.10 Typical High $89.13 | Professional | 55 · Aftercare only | $83.18 | $87.10 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $57.54 Typical High $58.88 | Professional | 56 · Pre-op care only | $56.23 | $57.54 | $58.88 |
Where Georgia sits
The same service costs 27.5 times more in Oklahoma 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
$1,023
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.