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 $89.13 Median $5,370.32 Typical High $7,585.78 | Facility | None | $89.13 | $5,370.32 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $123.03 Typical High $147.91 | Professional | None | $89.13 | $123.03 | $147.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $478.63 Median $851.14 Typical High $3,630.78 | Facility | None | $478.63 | $851.14 | $3,630.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $154.88 Typical High $263.03 | Professional | None | $100.00 | $154.88 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $112.20 Typical High $323.59 | Facility | None | $81.28 | $112.20 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $194.98 Typical High $309.03 | Professional | None | $83.18 | $194.98 | $309.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $100.00 Median $177.83 Typical High $316.23 | Professional | None | $100.00 | $177.83 | $316.23 |
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 $109.65 Median $186.21 Typical High $363.08 | Professional | None | $109.65 | $186.21 | $363.08 |
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 $43.65 Median $61.66 Typical High $74.13 | Professional | 52 · Reduced service | $43.65 | $61.66 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $24.55 Typical High $29.51 | Professional | 53 · Discontinued | $17.78 | $24.55 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $91.20 Typical High $112.20 | Professional | 54 · Surgery only | $66.07 | $91.20 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $18.62 Typical High $22.39 | Professional | 55 · Aftercare only | $13.18 | $18.62 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $12.30 Typical High $14.79 | Professional | 56 · Pre-op care only | $8.71 | $12.30 | $14.79 |
Where Georgia sits
The same service costs 3.7 times more in Alaska than in Florida. 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· 17th of 51
$162
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.