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 $489.78 Median $5,370.32 Typical High $7,943.28 | Facility | None | $489.78 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $151.36 Typical High $3,801.89 | Professional | None | $147.91 | $151.36 | $3,801.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,230.27 Typical High $7,244.36 | Facility | None | $588.84 | $1,230.27 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $141.25 Median $208.93 Typical High $331.13 | Professional | None | $141.25 | $208.93 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,548.13 Typical High $4,786.30 | Facility | None | $602.56 | $3,548.13 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $295.12 Typical High $416.87 | Professional | None | $158.49 | $295.12 | $416.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $162.18 Typical High $630.96 | Professional | None | $141.25 | $162.18 | $630.96 |
Oscar Health Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $251.19 | Professional | None | $218.78 | $218.78 | $251.19 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $3,715.35 Typical High $9,120.11 | Facility | None | $1,513.56 | $3,715.35 | $9,120.11 |
United Setting Professional Modifier None Typical Low $141.25 Median $234.42 Typical High $457.09 | Professional | None | $141.25 | $234.42 | $457.09 |
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 $74.13 Median $75.86 Typical High $91.20 | Professional | 52 · Reduced service | $74.13 | $75.86 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $30.20 Typical High $37.15 | Professional | 53 · Discontinued | $29.51 | $30.20 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $112.20 Typical High $138.04 | Professional | 54 · Surgery only | $112.20 | $112.20 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $22.91 Typical High $27.54 | Professional | 55 · Aftercare only | $22.39 | $22.91 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $15.14 Typical High $18.62 | Professional | 56 · Pre-op care only | $14.79 | $15.14 | $18.62 |
Where Georgia sits
The same service costs 17.8 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· 28th of 51
$282
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.