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 $85.11 Median $3,630.78 Typical High $7,943.28 | Facility | None | $85.11 | $3,630.78 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $229.09 | Professional | None | $85.11 | $85.11 | $229.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $1,258.93 Typical High $5,370.32 | Facility | None | $524.81 | $1,258.93 | $5,370.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $81.28 Median $112.20 Typical High $204.17 | Professional | None | $81.28 | $112.20 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $549.54 Typical High $2,398.83 | Facility | None | $457.09 | $549.54 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $134.90 Typical High $208.93 | Professional | None | $87.10 | $134.90 | $208.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $72.44 Median $91.20 Typical High $288.40 | Professional | None | $72.44 | $91.20 | $288.40 |
United Setting Facility Modifier None Typical Low $371.54 Median $645.65 Typical High $3,981.07 | Facility | None | $371.54 | $645.65 | $3,981.07 |
United Setting Professional Modifier None Typical Low $81.28 Median $131.83 Typical High $218.78 | Professional | None | $81.28 | $131.83 | $218.78 |
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 $42.66 Median $42.66 Typical High $48.98 | Professional | 52 · Reduced service | $42.66 | $42.66 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $19.95 | Professional | 53 · Discontinued | $16.98 | $16.98 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $64.57 Typical High $74.13 | Professional | 54 · Surgery only | $64.57 | $64.57 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $12.88 Typical High $14.79 | Professional | 55 · Aftercare only | $12.88 | $12.88 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $10.00 | Professional | 56 · Pre-op care only | $8.51 | $8.51 | $10.00 |
Where Georgia sits
The same service costs 6.5 times more in Tennessee than in New York. 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· 27th of 51
$135
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.