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 $933.25 Median $5,370.32 Typical High $7,943.28 | Facility | None | $933.25 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $933.25 Typical High $1,122.02 | Professional | None | $912.01 | $933.25 | $1,122.02 |
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 $776.25 Median $1,230.27 Typical High $1,862.09 | Professional | None | $776.25 | $1,230.27 | $1,862.09 |
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 $977.24 Median $1,621.81 Typical High $2,398.83 | Professional | None | $977.24 | $1,621.81 | $2,398.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $912.01 Median $1,000.00 Typical High $7,585.78 | Professional | None | $912.01 | $1,000.00 | $7,585.78 |
Oscar Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
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 $870.96 Median $1,445.44 Typical High $2,818.38 | Professional | None | $870.96 | $1,445.44 | $2,818.38 |
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 $457.09 Median $467.74 Typical High $512.86 | Professional | 52 · Reduced service | $457.09 | $467.74 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $186.21 Typical High $204.17 | Professional | 53 · Discontinued | $181.97 | $186.21 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $691.83 Typical High $758.58 | Professional | 54 · Surgery only | $676.08 | $691.83 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $138.04 Typical High $154.88 | Professional | 55 · Aftercare only | $134.90 | $138.04 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $93.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $91.20 | $93.33 | $102.33 |
Where Georgia sits
The same service costs 4.3 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· 34th of 51
$1,122
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.