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 $117.49 Median $3,548.13 Typical High $7,585.78 | Facility | None | $117.49 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $120.23 Typical High $288.40 | Professional | None | $70.79 | $120.23 | $288.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $549.54 Median $831.76 Typical High $1,659.59 | Facility | None | $549.54 | $831.76 | $1,659.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $89.13 Median $147.91 Typical High $269.15 | Professional | None | $89.13 | $147.91 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $138.04 Typical High $323.59 | Professional | None | $81.28 | $138.04 | $323.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $75.86 Median $141.25 Typical High $912.01 | Professional | None | $75.86 | $141.25 | $912.01 |
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 $72.44 Median $134.90 Typical High $316.23 | Professional | None | $72.44 | $134.90 | $316.23 |
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 $35.48 Median $56.23 Typical High $67.61 | Professional | 52 · Reduced service | $35.48 | $56.23 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $22.91 Typical High $26.92 | Professional | 53 · Discontinued | $14.13 | $22.91 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $85.11 Typical High $102.33 | Professional | 54 · Surgery only | $52.48 | $85.11 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $16.98 Typical High $20.42 | Professional | 55 · Aftercare only | $10.47 | $16.98 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $11.22 Typical High $13.49 | Professional | 56 · Pre-op care only | $7.08 | $11.22 | $13.49 |
Where Georgia sits
The same service costs 3.2 times more in Alaska than in Florida. 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· 15th of 51
$138
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.