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 $794.33 Median $5,623.41 Typical High $10,000.00 | Facility | None | $794.33 | $5,623.41 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $4,466.84 | Professional | None | $794.33 | $794.33 | $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 $380.19 Median $707.95 Typical High $1,000.00 | Professional | None | $380.19 | $707.95 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $7,943.28 Typical High $10,000.00 | Facility | None | $602.56 | $7,943.28 | $10,000.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $457.09 Median $478.63 Typical High $758.58 | Professional | None | $457.09 | $478.63 | $758.58 |
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 $776.25 Median $1,202.26 Typical High $1,862.09 | Professional | None | $776.25 | $1,202.26 | $1,862.09 |
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 $380.19 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $380.19 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $151.36 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $575.44 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $114.82 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $75.86 | $79.43 | $79.43 |
Where Georgia sits
The same service costs 16.2 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
$1,148
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.