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 $75.86 Median $3,548.13 Typical High $7,585.78 | Facility | None | $75.86 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $147.91 Typical High $213.80 | Professional | None | $64.57 | $147.91 | $213.80 |
Ambetter Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
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 $91.20 Median $177.83 Typical High $295.12 | Professional | None | $91.20 | $177.83 | $295.12 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $144.54 Median $263.03 Typical High $467.74 | Professional | 50 · Both sides | $144.54 | $263.03 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $186.21 Typical High $371.54 | Professional | None | $89.13 | $186.21 | $371.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $79.43 Median $194.98 Typical High $275.42 | Professional | None | $79.43 | $194.98 | $275.42 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,778.28 Typical High $2,818.38 | Facility | None | $691.83 | $1,778.28 | $2,818.38 |
United Setting Professional Modifier None Typical Low $79.43 Median $173.78 Typical High $371.54 | Professional | None | $79.43 | $173.78 | $371.54 |
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 $32.36 Median $67.61 Typical High $81.28 | Professional | 52 · Reduced service | $32.36 | $67.61 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $27.54 Typical High $33.11 | Professional | 53 · Discontinued | $12.88 | $27.54 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $102.33 Typical High $123.03 | Professional | 54 · Surgery only | $48.98 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $20.42 Typical High $24.55 | Professional | 55 · Aftercare only | $9.77 | $20.42 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $13.80 Typical High $16.22 | Professional | 56 · Pre-op care only | $6.46 | $13.80 | $16.22 |
Where Georgia sits
The same service costs 2.6 times more in Wisconsin than in Utah. 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
$170
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.