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 $125.89 Median $3,548.13 Typical High $7,585.78 | Facility | None | $125.89 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $141.25 Typical High $331.13 | Professional | None | $79.43 | $141.25 | $331.13 |
Ambetter Setting Professional Modifier None Typical Low $123.03 Median $269.15 Typical High $288.40 | Professional | None | $123.03 | $269.15 | $288.40 |
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 $95.50 Median $151.36 Typical High $251.19 | Professional | None | $95.50 | $151.36 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $104.71 Typical High $602.56 | Facility | None | $79.43 | $104.71 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $177.83 Typical High $295.12 | Professional | None | $79.43 | $177.83 | $295.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $91.20 Median $165.96 Typical High $245.47 | Professional | None | $91.20 | $165.96 | $245.47 |
United Setting Facility Modifier None Typical Low $331.13 Median $501.19 Typical High $2,454.71 | Facility | None | $331.13 | $501.19 | $2,454.71 |
United Setting Professional Modifier None Typical Low $100.00 Median $181.97 Typical High $346.74 | Professional | None | $100.00 | $181.97 | $346.74 |
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 $39.81 Median $60.26 Typical High $75.86 | Professional | 52 · Reduced service | $39.81 | $60.26 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $23.99 Typical High $30.20 | Professional | 53 · Discontinued | $15.85 | $23.99 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $91.20 Typical High $112.20 | Professional | 54 · Surgery only | $60.26 | $91.20 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $18.20 Typical High $22.91 | Professional | 55 · Aftercare only | $12.02 | $18.20 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $12.02 Typical High $15.14 | Professional | 56 · Pre-op care only | $7.94 | $12.02 | $15.14 |
Where Georgia sits
The same service costs 3.2 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· 19th 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.