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 $524.81 Median $5,370.32 Typical High $7,943.28 | Facility | None | $524.81 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $524.81 Typical High $630.96 | Professional | None | $512.86 | $524.81 | $630.96 |
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 $436.52 Median $691.83 Typical High $1,047.13 | Professional | None | $436.52 | $691.83 | $1,047.13 |
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 $549.54 Median $933.25 Typical High $1,380.38 | Professional | None | $549.54 | $933.25 | $1,380.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $4,677.35 | Professional | None | $512.86 | $562.34 | $4,677.35 |
Oscar Health Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
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 $489.78 Median $812.83 Typical High $1,584.89 | Professional | None | $489.78 | $812.83 | $1,584.89 |
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 $257.04 Median $263.03 Typical High $288.40 | Professional | 52 · Reduced service | $257.04 | $263.03 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $104.71 Typical High $114.82 | Professional | 53 · Discontinued | $102.33 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $398.11 Typical High $436.52 | Professional | 54 · Surgery only | $389.05 | $398.11 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $79.43 Typical High $87.10 | Professional | 55 · Aftercare only | $77.62 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $52.48 Typical High $57.54 | Professional | 56 · Pre-op care only | $51.29 | $52.48 | $57.54 |
Where Georgia sits
The same service costs 3.9 times more in Wisconsin 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· 25th of 51
$708
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.