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 $141.25 Median $3,630.78 Typical High $7,943.28 | Facility | None | $141.25 | $3,630.78 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $204.17 | Professional | None | $123.03 | $123.03 | $204.17 |
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 $128.82 Median $199.53 Typical High $295.12 | Professional | None | $128.82 | $199.53 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $218.78 Typical High $389.05 | Professional | None | $151.36 | $218.78 | $389.05 |
Kaiser Permanente Setting Professional Modifier None Typical Low $123.03 Median $154.88 Typical High $446.68 | Professional | None | $123.03 | $154.88 | $446.68 |
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 $134.90 Median $199.53 Typical High $338.84 | Professional | None | $134.90 | $199.53 | $338.84 |
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 $60.26 Median $61.66 Typical High $74.13 | Professional | 52 · Reduced service | $60.26 | $61.66 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $25.12 Typical High $30.20 | Professional | 53 · Discontinued | $24.55 | $25.12 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $93.33 Typical High $112.20 | Professional | 54 · Surgery only | $91.20 | $93.33 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.62 Typical High $22.39 | Professional | 55 · Aftercare only | $18.20 | $18.62 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.30 Typical High $15.14 | Professional | 56 · Pre-op care only | $12.30 | $12.30 | $15.14 |
Where Georgia sits
The same service costs 3.7 times more in Alaska 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· 23rd of 51
$195
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.