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 $14.79 Median $5,370.32 Typical High $7,585.78 | Facility | None | $14.79 | $5,370.32 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $14.79 Median $28.18 Typical High $37.15 | Professional | None | $14.79 | $28.18 | $37.15 |
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 $17.78 Median $32.36 Typical High $61.66 | Professional | None | $17.78 | $32.36 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $2,398.83 Typical High $4,265.80 | Facility | None | $50.12 | $2,398.83 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $14.79 Median $36.31 Typical High $61.66 | Professional | None | $14.79 | $36.31 | $61.66 |
Kaiser Permanente Setting Professional Modifier None Typical Low $16.22 Median $34.67 Typical High $79.43 | Professional | None | $16.22 | $34.67 | $79.43 |
Oscar Health Setting Professional Modifier None Typical Low $21.38 Median $24.55 Typical High $43.65 | Professional | None | $21.38 | $24.55 | $43.65 |
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 $18.62 Median $41.69 Typical High $77.62 | Professional | None | $18.62 | $41.69 | $77.62 |
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 $7.41 Median $12.88 Typical High $17.38 | Professional | 52 · Reduced service | $7.41 | $12.88 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.95 Median $5.25 Typical High $6.92 | Professional | 53 · Discontinued | $2.95 | $5.25 | $6.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $10.96 Median $19.05 Typical High $26.30 | Professional | 54 · Surgery only | $10.96 | $19.05 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.19 Median $3.98 Typical High $5.25 | Professional | 55 · Aftercare only | $2.19 | $3.98 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.48 Median $2.57 Typical High $3.47 | Professional | 56 · Pre-op care only | $1.48 | $2.57 | $3.47 |
Where Georgia sits
The same service costs 3.9 times more in Alaska than in Hawaii. 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· 27th of 51
$35.48
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.