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 $11.48 Median $11.48 Typical High $12.88 | Facility | None | $11.48 | $11.48 | $12.88 |
Aetna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $13.80 | Professional | None | $11.48 | $11.48 | $13.80 |
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 $11.48 Median $16.22 Typical High $91.20 | Professional | None | $11.48 | $16.22 | $91.20 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $19.05 Median $23.99 Typical High $89.13 | Professional | 50 · Both sides | $19.05 | $23.99 | $89.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $7.94 Median $10.72 Typical High $50.12 | Professional | 62 · Two surgeons | $7.94 | $10.72 | $50.12 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $467.74 Typical High $1,659.59 | Facility | None | $338.84 | $467.74 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $14.45 Median $19.50 Typical High $36.31 | Professional | None | $14.45 | $19.50 | $36.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $10.72 Median $12.59 Typical High $218.78 | Professional | None | $10.72 | $12.59 | $218.78 |
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 $12.59 Median $19.50 Typical High $33.11 | Professional | None | $12.59 | $19.50 | $33.11 |
4 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 $5.75 Median $5.75 Typical High $6.92 | Professional | 52 · Reduced service | $5.75 | $5.75 | $6.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $2.29 Typical High $2.75 | Professional | 53 · Discontinued | $2.29 | $2.29 | $2.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.70 Median $1.70 Typical High $2.04 | Professional | 55 · Aftercare only | $1.70 | $1.70 | $2.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.12 Typical High $1.38 | Professional | 56 · Pre-op care only | $1.12 | $1.12 | $1.38 |
Where Georgia sits
The same service costs 12.3 times more in Florida than in Kentucky. 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· 24th of 51
$19.95
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.