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 $213.80 Median $5,370.32 Typical High $10,000.00 | Facility | None | $213.80 | $5,370.32 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $218.78 | Professional | None | $190.55 | $190.55 | $218.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $1,348.96 Typical High $7,244.36 | Facility | None | $691.83 | $1,348.96 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $263.03 Typical High $354.81 | Professional | None | $158.49 | $263.03 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,754.23 Typical High $3,801.89 | Facility | None | $758.58 | $2,754.23 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $316.23 Typical High $575.44 | Professional | None | $229.09 | $316.23 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $162.18 Median $194.98 Typical High $1,258.93 | Professional | None | $162.18 | $194.98 | $1,258.93 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $2,884.03 Typical High $8,709.64 | Facility | None | $1,258.93 | $2,884.03 | $8,709.64 |
United Setting Professional Modifier None Typical Low $204.17 Median $295.12 Typical High $467.74 | Professional | None | $204.17 | $295.12 | $467.74 |
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 $95.50 Median $95.50 Typical High $107.15 | Professional | 52 · Reduced service | $95.50 | $95.50 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $42.66 | Professional | 53 · Discontinued | $38.02 | $38.02 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $141.25 Typical High $162.18 | Professional | 54 · Surgery only | $141.25 | $141.25 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $32.36 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $21.38 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $21.38 |
Where Georgia sits
The same service costs 10.2 times more in Oklahoma 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· 26th of 51
$302
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.