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 $346.74 Median $3,548.13 Typical High $7,585.78 | Facility | None | $346.74 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $131.83 Typical High $2,344.23 | Professional | None | $125.89 | $131.83 | $2,344.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $1,000.00 Typical High $5,754.40 | Facility | None | $389.05 | $1,000.00 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $169.82 Typical High $281.84 | Professional | None | $117.49 | $169.82 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $2,344.23 Typical High $3,090.30 | Facility | None | $398.11 | $2,344.23 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $234.42 Typical High $363.08 | Professional | None | $131.83 | $234.42 | $363.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $112.20 Median $123.03 Typical High $436.52 | Professional | None | $112.20 | $123.03 | $436.52 |
Oscar Health Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $7,585.78 | Facility | None | $954.99 | $1,995.26 | $7,585.78 |
United Setting Professional Modifier None Typical Low $120.23 Median $190.55 Typical High $389.05 | Professional | None | $120.23 | $190.55 | $389.05 |
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 $63.10 Median $66.07 Typical High $81.28 | Professional | 52 · Reduced service | $63.10 | $66.07 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $26.30 Typical High $32.36 | Professional | 53 · Discontinued | $25.12 | $26.30 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $97.72 Typical High $120.23 | Professional | 54 · Surgery only | $95.50 | $97.72 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.95 Typical High $23.99 | Professional | 55 · Aftercare only | $19.05 | $19.95 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $13.18 Typical High $16.22 | Professional | 56 · Pre-op care only | $12.59 | $13.18 | $16.22 |
Where Georgia sits
The same service costs 12.9 times more in Arkansas 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· 31st of 51
$219
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.