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 $323.59 Median $4,897.79 Typical High $7,943.28 | Facility | None | $323.59 | $4,897.79 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $338.84 Typical High $371.54 | Professional | None | $169.82 | $338.84 | $371.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $851.14 Typical High $4,570.88 | Facility | None | $389.05 | $851.14 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $309.03 Typical High $501.19 | Professional | None | $169.82 | $309.03 | $501.19 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $316.23 Median $524.81 Typical High $776.25 | Professional | 50 · Both sides | $316.23 | $524.81 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $977.24 Typical High $1,288.25 | Facility | None | $398.11 | $977.24 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $323.59 Typical High $741.31 | Professional | None | $173.78 | $323.59 | $741.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $316.23 Typical High $602.56 | Professional | None | $154.88 | $316.23 | $602.56 |
United Setting Facility Modifier None Typical Low $501.19 Median $724.44 Typical High $3,548.13 | Facility | None | $501.19 | $724.44 | $3,548.13 |
United Setting Professional Modifier None Typical Low $169.82 Median $338.84 Typical High $758.58 | Professional | None | $169.82 | $338.84 | $758.58 |
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 $85.11 Median $151.36 Typical High $181.97 | Professional | 52 · Reduced service | $85.11 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $60.26 Typical High $74.13 | Professional | 53 · Discontinued | $33.88 | $60.26 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $223.87 Typical High $275.42 | Professional | 54 · Surgery only | $128.82 | $223.87 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $44.67 Typical High $54.95 | Professional | 55 · Aftercare only | $25.70 | $44.67 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $30.20 Typical High $37.15 | Professional | 56 · Pre-op care only | $16.98 | $30.20 | $37.15 |
Where Georgia sits
The same service costs 3.9 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· 24th of 51
$363
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.