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 $128.82 Median $302.00 Typical High $724.44 | Professional | None | $128.82 | $302.00 | $724.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,000.00 Typical High $4,570.88 | Facility | None | $512.86 | $1,000.00 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $251.19 Typical High $446.68 | Professional | None | $134.90 | $251.19 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $977.24 Typical High $1,318.26 | Facility | None | $524.81 | $977.24 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $288.40 Typical High $645.65 | Professional | None | $128.82 | $288.40 | $645.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $117.49 Median $275.42 Typical High $524.81 | Professional | None | $117.49 | $275.42 | $524.81 |
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 $125.89 Median $275.42 Typical High $645.65 | Professional | None | $125.89 | $275.42 | $645.65 |
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 $64.57 Median $128.82 Typical High $158.49 | Professional | 52 · Reduced service | $64.57 | $128.82 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $51.29 Typical High $64.57 | Professional | 53 · Discontinued | $25.70 | $51.29 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $194.98 Typical High $239.88 | Professional | 54 · Surgery only | $95.50 | $194.98 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $38.90 Typical High $47.86 | Professional | 55 · Aftercare only | $19.05 | $38.90 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $25.70 Typical High $32.36 | Professional | 56 · Pre-op care only | $12.88 | $25.70 | $32.36 |
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· 22nd of 51
$302
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.