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 $54.95 Median $3,548.13 Typical High $7,585.78 | Facility | None | $54.95 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $89.13 Typical High $234.42 | Professional | None | $46.77 | $89.13 | $234.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $380.19 Median $776.25 Typical High $3,630.78 | Facility | None | $380.19 | $776.25 | $3,630.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $66.07 Median $109.65 Typical High $162.18 | Professional | None | $66.07 | $109.65 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $77.62 Typical High $436.52 | Facility | None | $60.26 | $77.62 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $131.83 Typical High $245.47 | Professional | None | $64.57 | $131.83 | $245.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $52.48 Median $102.33 Typical High $169.82 | Professional | None | $52.48 | $102.33 | $169.82 |
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 $64.57 Median $128.82 Typical High $245.47 | Professional | None | $64.57 | $128.82 | $245.47 |
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 $23.44 Median $44.67 Typical High $52.48 | Professional | 52 · Reduced service | $23.44 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $17.78 Typical High $21.38 | Professional | 53 · Discontinued | $9.33 | $17.78 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $66.07 Typical High $79.43 | Professional | 54 · Surgery only | $35.48 | $66.07 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $13.18 Typical High $15.85 | Professional | 55 · Aftercare only | $7.08 | $13.18 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $8.91 Typical High $10.47 | Professional | 56 · Pre-op care only | $4.68 | $8.91 | $10.47 |
Where Georgia sits
The same service costs 2.8 times more in Alaska than in Pennsylvania. 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· 21st of 51
$120
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.