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 $169.82 Median $3,630.78 Typical High $7,943.28 | Facility | None | $169.82 | $3,630.78 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $169.82 Typical High $223.87 | Professional | None | $154.88 | $169.82 | $223.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $7,943.28 | Facility | None | $7,943.28 | $7,943.28 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $223.87 Median $323.59 Typical High $380.19 | Professional | None | $223.87 | $323.59 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $724.44 Typical High $2,691.53 | Facility | None | $501.19 | $724.44 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $416.87 Typical High $575.44 | Professional | None | $295.12 | $416.87 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $204.17 Median $245.47 Typical High $1,000.00 | Professional | None | $204.17 | $245.47 | $1,000.00 |
United Setting Facility Modifier None Typical Low $79.43 Median $158.49 Typical High $1,778.28 | Facility | None | $79.43 | $158.49 | $1,778.28 |
United Setting Professional Modifier None Typical Low $181.97 Median $346.74 Typical High $501.19 | Professional | None | $181.97 | $346.74 | $501.19 |
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 $77.62 Median $77.62 Typical High $95.50 | Professional | 52 · Reduced service | $77.62 | $77.62 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $38.02 | Professional | 53 · Discontinued | $30.90 | $30.90 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $117.49 Typical High $141.25 | Professional | 54 · Surgery only | $117.49 | $117.49 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $23.44 Typical High $28.18 | Professional | 55 · Aftercare only | $23.44 | $23.44 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.49 Typical High $19.05 | Professional | 56 · Pre-op care only | $15.49 | $15.49 | $19.05 |
Where Georgia sits
The same service costs 7.2 times more in Oklahoma than in Virginia. 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· 14th of 51
$324
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.