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 $45.71 Median $45.71 Typical High $51.29 | Facility | None | $45.71 | $45.71 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $54.95 | Professional | None | $45.71 | $45.71 | $54.95 |
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 $45.71 Median $67.61 Typical High $114.82 | Professional | None | $45.71 | $67.61 | $114.82 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $74.13 Median $102.33 Typical High $169.82 | Professional | 50 · Both sides | $74.13 | $102.33 | $169.82 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $30.20 Median $43.65 Typical High $72.44 | Professional | 62 · Two surgeons | $30.20 | $43.65 | $72.44 |
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 $57.54 Median $77.62 Typical High $144.54 | Professional | None | $57.54 | $77.62 | $144.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $41.69 Median $48.98 Typical High $218.78 | Professional | None | $41.69 | $48.98 | $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 $50.12 Median $75.86 Typical High $131.83 | Professional | None | $50.12 | $75.86 | $131.83 |
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 $22.39 Median $22.39 Typical High $27.54 | Professional | 52 · Reduced service | $22.39 | $22.39 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.12 Typical High $10.96 | Professional | 53 · Discontinued | $9.12 | $9.12 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $6.76 Typical High $8.13 | Professional | 55 · Aftercare only | $6.76 | $6.76 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.57 Typical High $5.50 | Professional | 56 · Pre-op care only | $4.57 | $4.57 | $5.50 |
Where Georgia sits
The same service costs 4.7 times more in Wisconsin 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· 19th of 51
$81.28
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.