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 $30.20 Median $3,548.13 Typical High $7,585.78 | Facility | None | $30.20 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $102.33 Typical High $269.15 | Professional | None | $28.18 | $102.33 | $269.15 |
Ambetter Setting Professional Modifier None Typical Low $28.18 Median $56.23 Typical High $194.98 | Professional | None | $28.18 | $56.23 | $194.98 |
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 $37.15 Median $81.28 Typical High $208.93 | Professional | None | $37.15 | $81.28 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $109.65 Typical High $346.74 | Facility | None | $77.62 | $109.65 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $89.13 Typical High $239.88 | Professional | None | $35.48 | $89.13 | $239.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $32.36 Median $102.33 Typical High $173.78 | Professional | None | $32.36 | $102.33 | $173.78 |
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 $33.88 Median $102.33 Typical High $245.47 | Professional | None | $33.88 | $102.33 | $245.47 |
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 $14.13 Median $50.12 Typical High $56.23 | Professional | 52 · Reduced service | $14.13 | $50.12 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $19.95 Typical High $22.39 | Professional | 53 · Discontinued | $5.62 | $19.95 | $22.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $21.38 Median $75.86 Typical High $83.18 | Professional | 54 · Surgery only | $21.38 | $75.86 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $15.14 Typical High $16.60 | Professional | 55 · Aftercare only | $4.27 | $15.14 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $10.00 Typical High $11.22 | Professional | 56 · Pre-op care only | $2.82 | $10.00 | $11.22 |
Where Georgia sits
The same service costs 5.4 times more in Wisconsin than in Hawaii. 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
$102
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.