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 $630.96 Median $3,548.13 Typical High $7,585.78 | Facility | None | $630.96 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $691.83 | Professional | None | $363.08 | $363.08 | $691.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $1,122.02 Typical High $7,244.36 | Facility | None | $389.05 | $1,122.02 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $316.23 Median $489.78 Typical High $831.76 | Professional | None | $316.23 | $489.78 | $831.76 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $549.54 Median $741.31 Typical High $1,288.25 | Professional | 50 · Both sides | $549.54 | $741.31 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $3,019.95 Typical High $3,801.89 | Facility | None | $398.11 | $3,019.95 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $575.44 Typical High $977.24 | Professional | None | $407.38 | $575.44 | $977.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $316.23 Median $407.38 Typical High $891.25 | Professional | None | $316.23 | $407.38 | $891.25 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,479.11 Typical High $5,011.87 | Facility | None | $851.14 | $1,479.11 | $5,011.87 |
United Setting Professional Modifier None Typical Low $371.54 Median $575.44 Typical High $1,096.48 | Professional | None | $371.54 | $575.44 | $1,096.48 |
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 $181.97 Median $181.97 Typical High $213.80 | Professional | 52 · Reduced service | $181.97 | $181.97 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $87.10 | Professional | 53 · Discontinued | $72.44 | $72.44 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $269.15 Typical High $323.59 | Professional | 54 · Surgery only | $269.15 | $269.15 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $53.70 Typical High $64.57 | Professional | 55 · Aftercare only | $53.70 | $53.70 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $43.65 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $43.65 |
Where Georgia sits
The same service costs 7.8 times more in Oklahoma than in New York. 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· 28th of 51
$550
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.