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 $48.98 Median $5,370.32 Typical High $7,585.78 | Facility | None | $48.98 | $5,370.32 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $75.86 Typical High $138.04 | Professional | None | $48.98 | $75.86 | $138.04 |
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 $48.98 Median $72.44 Typical High $109.65 | Professional | None | $48.98 | $72.44 | $109.65 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $81.28 Median $109.65 Typical High $165.96 | Professional | 50 · Both sides | $81.28 | $109.65 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $74.13 Typical High $218.78 | Facility | None | $57.54 | $74.13 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $97.72 Typical High $173.78 | Professional | None | $57.54 | $97.72 | $173.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $53.70 Median $93.33 Typical High $134.90 | Professional | None | $53.70 | $93.33 | $134.90 |
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 $52.48 Median $91.20 Typical High $181.97 | Professional | None | $52.48 | $91.20 | $181.97 |
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 $24.55 Median $34.67 Typical High $38.90 | Professional | 52 · Reduced service | $24.55 | $34.67 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $14.13 Typical High $15.49 | Professional | 53 · Discontinued | $9.77 | $14.13 | $15.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $52.48 Typical High $58.88 | Professional | 54 · Surgery only | $37.15 | $52.48 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $10.47 Typical High $11.75 | Professional | 55 · Aftercare only | $7.41 | $10.47 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $7.08 Typical High $7.76 | Professional | 56 · Pre-op care only | $4.90 | $7.08 | $7.76 |
Where Georgia sits
The same service costs 3.6 times more in Alaska than in Kentucky. 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
$81.28
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.