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 $177.83 Median $5,370.32 Typical High $7,585.78 | Facility | None | $177.83 | $5,370.32 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $275.42 Typical High $309.03 | Professional | None | $177.83 | $275.42 | $309.03 |
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 $158.49 Median $245.47 Typical High $389.05 | Professional | None | $158.49 | $245.47 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $186.21 Typical High $501.19 | Facility | None | $134.90 | $186.21 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $331.13 Typical High $676.08 | Professional | None | $199.53 | $331.13 | $676.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $194.98 Median $380.19 Typical High $549.54 | Professional | None | $194.98 | $380.19 | $549.54 |
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 $169.82 Median $309.03 Typical High $741.31 | Professional | None | $169.82 | $309.03 | $741.31 |
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 $87.10 Median $125.89 Typical High $154.88 | Professional | 52 · Reduced service | $87.10 | $125.89 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $50.12 Typical High $61.66 | Professional | 53 · Discontinued | $35.48 | $50.12 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $186.21 Typical High $229.09 | Professional | 54 · Surgery only | $131.83 | $186.21 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $37.15 Typical High $45.71 | Professional | 55 · Aftercare only | $26.30 | $37.15 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $25.12 Typical High $30.90 | Professional | 56 · Pre-op care only | $17.78 | $25.12 | $30.90 |
Where Georgia sits
The same service costs 4.0 times more in Alaska than in Maryland. 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· 28th of 51
$269
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.