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 $70.79 Median $5,370.32 Typical High $7,585.78 | Facility | None | $70.79 | $5,370.32 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $93.33 Typical High $107.15 | Professional | None | $70.79 | $93.33 | $107.15 |
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 $64.57 Median $97.72 Typical High $158.49 | Professional | None | $64.57 | $97.72 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $95.50 Typical High $281.84 | Facility | None | $70.79 | $95.50 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $120.23 Typical High $229.09 | Professional | None | $79.43 | $120.23 | $229.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $79.43 Median $128.82 Typical High $186.21 | Professional | None | $79.43 | $128.82 | $186.21 |
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 $70.79 Median $117.49 Typical High $251.19 | Professional | None | $70.79 | $117.49 | $251.19 |
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 $34.67 Median $42.66 Typical High $52.48 | Professional | 52 · Reduced service | $34.67 | $42.66 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $17.38 Typical High $20.89 | Professional | 53 · Discontinued | $14.13 | $17.38 | $20.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $64.57 Typical High $79.43 | Professional | 54 · Surgery only | $52.48 | $64.57 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $12.88 Typical High $15.85 | Professional | 55 · Aftercare only | $10.47 | $12.88 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $8.71 Typical High $10.47 | Professional | 56 · Pre-op care only | $7.08 | $8.71 | $10.47 |
Where Georgia sits
The same service costs 3.8 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· 26th of 51
$107
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.