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 $870.96 Median $5,370.32 Typical High $7,943.28 | Facility | None | $870.96 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $870.96 Typical High $1,047.13 | Professional | None | $851.14 | $870.96 | $1,047.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $2,089.30 Typical High $12,022.64 | Facility | None | $1,047.13 | $2,089.30 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $724.44 Median $1,148.15 Typical High $1,778.28 | Professional | None | $724.44 | $1,148.15 | $1,778.28 |
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 $912.01 Median $1,445.44 Typical High $2,290.87 | Professional | None | $912.01 | $1,445.44 | $2,290.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $851.14 Median $933.25 Typical High $7,079.46 | Professional | None | $851.14 | $933.25 | $7,079.46 |
Oscar Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
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 $812.83 Median $1,288.25 Typical High $2,630.27 | Professional | None | $812.83 | $1,288.25 | $2,630.27 |
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 $426.58 Median $436.52 Typical High $478.63 | Professional | 52 · Reduced service | $426.58 | $436.52 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $173.78 Typical High $190.55 | Professional | 53 · Discontinued | $169.82 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $660.69 Typical High $724.44 | Professional | 54 · Surgery only | $645.65 | $660.69 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $131.83 Typical High $144.54 | Professional | 55 · Aftercare only | $128.82 | $131.83 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $87.10 Typical High $95.50 | Professional | 56 · Pre-op care only | $85.11 | $87.10 | $95.50 |
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· 21st of 51
$1,148
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.