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 $302.00 Median $4,466.84 Typical High $7,585.78 | Facility | None | $302.00 | $4,466.84 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $295.12 Typical High $331.13 | Professional | None | $144.54 | $295.12 | $331.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $478.63 Median $851.14 Typical High $3,630.78 | Facility | None | $478.63 | $851.14 | $3,630.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $275.42 Typical High $436.52 | Professional | None | $158.49 | $275.42 | $436.52 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $269.15 Median $436.52 Typical High $660.69 | Professional | 50 · Both sides | $269.15 | $436.52 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $288.40 Typical High $776.25 | Facility | None | $213.80 | $288.40 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $281.84 Typical High $645.65 | Professional | None | $147.91 | $281.84 | $645.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $131.83 Median $275.42 Typical High $524.81 | Professional | None | $131.83 | $275.42 | $524.81 |
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 $141.25 Median $295.12 Typical High $660.69 | Professional | None | $141.25 | $295.12 | $660.69 |
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 $72.44 Median $131.83 Typical High $162.18 | Professional | 52 · Reduced service | $72.44 | $131.83 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $52.48 Typical High $64.57 | Professional | 53 · Discontinued | $28.84 | $52.48 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $199.53 Typical High $239.88 | Professional | 54 · Surgery only | $109.65 | $199.53 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $39.81 Typical High $48.98 | Professional | 55 · Aftercare only | $21.88 | $39.81 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $26.30 Typical High $32.36 | Professional | 56 · Pre-op care only | $14.45 | $26.30 | $32.36 |
Where Georgia sits
The same service costs 3.2 times more in Wisconsin 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· 20th of 51
$295
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.