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 $104.71 Median $5,370.32 Typical High $7,943.28 | Facility | None | $104.71 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $104.71 Typical High $5,370.32 | Professional | None | $102.33 | $104.71 | $5,370.32 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,023.29 Median $3,090.30 Typical High $6,760.83 | Facility | None | $1,023.29 | $3,090.30 | $6,760.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $91.20 Median $112.20 Typical High $208.93 | Professional | None | $91.20 | $112.20 | $208.93 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $138.04 Median $165.96 Typical High $309.03 | Professional | 50 · Both sides | $138.04 | $165.96 | $309.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
United Setting Facility Modifier None Typical Low $2,691.53 Median $5,128.61 Typical High $6,918.31 | Facility | None | $2,691.53 | $5,128.61 | $6,918.31 |
United Setting Professional Modifier None Typical Low $120.23 Median $181.97 Typical High $331.13 | Professional | None | $120.23 | $181.97 | $331.13 |
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 $51.29 Median $51.29 Typical High $52.48 | Professional | 52 · Reduced service | $51.29 | $51.29 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.42 Typical High $21.38 | Professional | 53 · Discontinued | $20.42 | $20.42 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $75.86 Typical High $79.43 | Professional | 54 · Surgery only | $75.86 | $75.86 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $15.85 | Professional | 55 · Aftercare only | $15.14 | $15.14 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $10.47 | Professional | 56 · Pre-op care only | $10.23 | $10.23 | $10.47 |
Where Georgia sits
The same service costs 51.3 times more in Oklahoma than in Kentucky. 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· 29th of 51
$178
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.