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 $239.88 Median $3,548.13 Typical High $7,585.78 | Facility | None | $239.88 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $239.88 Typical High $269.15 | Professional | None | $162.18 | $239.88 | $269.15 |
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 $147.91 Median $239.88 Typical High $371.54 | Professional | None | $147.91 | $239.88 | $371.54 |
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 $181.97 Median $302.00 Typical High $575.44 | Professional | None | $181.97 | $302.00 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $177.83 Median $323.59 Typical High $467.74 | Professional | None | $177.83 | $323.59 | $467.74 |
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 $162.18 Median $295.12 Typical High $630.96 | Professional | None | $162.18 | $295.12 | $630.96 |
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 $81.28 Median $112.20 Typical High $131.83 | Professional | 52 · Reduced service | $81.28 | $112.20 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $44.67 Typical High $52.48 | Professional | 53 · Discontinued | $32.36 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $169.82 Typical High $194.98 | Professional | 54 · Surgery only | $120.23 | $169.82 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $33.88 Typical High $38.90 | Professional | 55 · Aftercare only | $23.99 | $33.88 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $22.39 Typical High $26.30 | Professional | 56 · Pre-op care only | $16.22 | $22.39 | $26.30 |
Where Georgia sits
The same service costs 3.9 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· 22nd of 51
$263
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.