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 $109.65 Median $3,630.78 Typical High $7,943.28 | Facility | None | $109.65 | $3,630.78 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $109.65 Typical High $120.23 | Professional | None | $107.15 | $109.65 | $120.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $380.19 Median $776.25 Typical High $3,630.78 | Facility | None | $380.19 | $776.25 | $3,630.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $93.33 Median $147.91 Typical High $229.09 | Professional | None | $93.33 | $147.91 | $229.09 |
CareSource Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $645.65 Typical High $1,659.59 | Facility | None | $501.19 | $645.65 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $169.82 Typical High $295.12 | Professional | None | $120.23 | $169.82 | $295.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $91.20 Median $114.82 Typical High $1,000.00 | Professional | None | $91.20 | $114.82 | $1,000.00 |
United Setting Facility Modifier None Typical Low $79.43 Median $158.49 Typical High $1,778.28 | Facility | None | $79.43 | $158.49 | $1,778.28 |
United Setting Professional Modifier None Typical Low $100.00 Median $169.82 Typical High $323.59 | Professional | None | $100.00 | $169.82 | $323.59 |
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 $53.70 Median $54.95 Typical High $60.26 | Professional | 52 · Reduced service | $53.70 | $54.95 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.88 Typical High $23.99 | Professional | 53 · Discontinued | $21.38 | $21.88 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $83.18 Typical High $91.20 | Professional | 54 · Surgery only | $79.43 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $16.60 Typical High $18.20 | Professional | 55 · Aftercare only | $15.85 | $16.60 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.96 Typical High $12.02 | Professional | 56 · Pre-op care only | $10.72 | $10.96 | $12.02 |
Where Georgia sits
The same service costs 4.0 times more in Alaska than in Florida. 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· 19th of 51
$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.