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 $549.54 Median $5,370.32 Typical High $7,943.28 | Facility | None | $549.54 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $549.54 Typical High $660.69 | Professional | None | $537.03 | $549.54 | $660.69 |
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 $457.09 Median $741.31 Typical High $1,122.02 | Professional | None | $457.09 | $741.31 | $1,122.02 |
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 $575.44 Median $954.99 Typical High $1,445.44 | Professional | None | $575.44 | $954.99 | $1,445.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $537.03 Median $602.56 Typical High $4,786.30 | Professional | None | $537.03 | $602.56 | $4,786.30 |
Oscar Health Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | None | $870.96 | $870.96 | $870.96 |
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 $512.86 Median $831.76 Typical High $1,659.59 | Professional | None | $512.86 | $831.76 | $1,659.59 |
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 $269.15 Median $275.42 Typical High $302.00 | Professional | 52 · Reduced service | $269.15 | $275.42 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $109.65 Typical High $123.03 | Professional | 53 · Discontinued | $107.15 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $416.87 Typical High $457.09 | Professional | 54 · Surgery only | $407.38 | $416.87 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $83.18 Typical High $91.20 | Professional | 55 · Aftercare only | $81.28 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $54.95 Typical High $60.26 | Professional | 56 · Pre-op care only | $53.70 | $54.95 | $60.26 |
Where Georgia sits
The same service costs 3.8 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· 26th of 51
$741
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.