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 $2,754.23 Median $5,011.87 Typical High $10,964.78 | Facility | None | $2,754.23 | $5,011.87 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $1,000.00 Typical High $5,370.32 | Professional | None | $64.57 | $1,000.00 | $5,370.32 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $2,511.89 Typical High $11,220.18 | Facility | None | $1,096.48 | $2,511.89 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $1,479.11 Typical High $1,659.59 | Professional | None | $1,318.26 | $1,479.11 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,995.26 Median $2,238.72 Typical High $2,454.71 | Professional | 50 · Both sides | $1,995.26 | $2,238.72 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $758.58 Typical High $4,265.80 | Facility | None | $501.19 | $758.58 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $4,365.16 | Professional | None | $4,365.16 | $4,365.16 | $4,365.16 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $3,715.35 Typical High $9,549.93 | Facility | None | $1,513.56 | $3,715.35 | $9,549.93 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,621.81 Typical High $2,570.40 | Professional | None | $954.99 | $1,621.81 | $2,570.40 |
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 $32.36 Median $457.09 Typical High $602.56 | Professional | 52 · Reduced service | $32.36 | $457.09 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $181.97 Typical High $239.88 | Professional | 53 · Discontinued | $12.88 | $181.97 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $691.83 Typical High $912.01 | Professional | 54 · Surgery only | $48.98 | $691.83 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $138.04 Typical High $181.97 | Professional | 55 · Aftercare only | $9.77 | $138.04 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $91.20 Typical High $154.88 | Professional | 56 · Pre-op care only | $70.79 | $91.20 | $154.88 |
Where Georgia sits
The same service costs 50.1 times more in Oklahoma than in North Carolina. 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· 20th of 51
$1,660
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.