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 $616.60 Median $4,897.79 Typical High $7,943.28 | Facility | None | $616.60 | $4,897.79 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $562.34 Typical High $676.08 | Professional | None | $134.90 | $562.34 | $676.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $7,943.28 | Facility | None | $7,943.28 | $7,943.28 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $398.11 Typical High $1,047.13 | Professional | None | $158.49 | $398.11 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $407.38 Typical High $1,318.26 | Professional | None | $144.54 | $407.38 | $1,318.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $131.83 Median $645.65 Typical High $1,122.02 | Professional | None | $131.83 | $645.65 | $1,122.02 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,778.28 Typical High $2,818.38 | Facility | None | $691.83 | $1,778.28 | $2,818.38 |
United Setting Professional Modifier None Typical Low $128.82 Median $489.78 Typical High $1,380.38 | Professional | None | $128.82 | $489.78 | $1,380.38 |
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 $67.61 Median $275.42 Typical High $338.84 | Professional | 52 · Reduced service | $67.61 | $275.42 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $109.65 Typical High $134.90 | Professional | 53 · Discontinued | $26.92 | $109.65 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $416.87 Typical High $512.86 | Professional | 54 · Surgery only | $102.33 | $416.87 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $83.18 Typical High $102.33 | Professional | 55 · Aftercare only | $20.42 | $83.18 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $54.95 Typical High $67.61 | Professional | 56 · Pre-op care only | $13.49 | $54.95 | $67.61 |
Where Georgia sits
The same service costs 4.0 times more in Wisconsin than in Maryland. 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
$437
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.