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 $60.26 Median $5,370.32 Typical High $7,585.78 | Facility | None | $60.26 | $5,370.32 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $89.13 Typical High $117.49 | Professional | None | $60.26 | $89.13 | $117.49 |
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 $57.54 Median $112.20 Typical High $208.93 | Professional | None | $57.54 | $112.20 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $2,511.89 Typical High $4,265.80 | Facility | None | $512.86 | $2,511.89 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $120.23 Typical High $229.09 | Professional | None | $61.66 | $120.23 | $229.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $54.95 Median $95.50 Typical High $275.42 | Professional | None | $54.95 | $95.50 | $275.42 |
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 $64.57 Median $125.89 Typical High $281.84 | Professional | None | $64.57 | $125.89 | $281.84 |
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 $29.51 Median $41.69 Typical High $50.12 | Professional | 52 · Reduced service | $29.51 | $41.69 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $16.60 Typical High $19.95 | Professional | 53 · Discontinued | $11.75 | $16.60 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $63.10 Typical High $75.86 | Professional | 54 · Surgery only | $44.67 | $63.10 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $12.59 Typical High $15.14 | Professional | 55 · Aftercare only | $8.91 | $12.59 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $8.32 Typical High $10.00 | Professional | 56 · Pre-op care only | $5.89 | $8.32 | $10.00 |
Where Georgia sits
The same service costs 3.7 times more in Wisconsin 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· 22nd of 51
$112
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.