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 $54.95 Median $3,548.13 Typical High $7,585.78 | Facility | None | $54.95 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $100.00 Typical High $245.47 | Professional | None | $52.48 | $100.00 | $245.47 |
Ambetter Setting Professional Modifier None Typical Low $45.71 Median $147.91 Typical High $194.98 | Professional | None | $45.71 | $147.91 | $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 $67.61 Median $112.20 Typical High $186.21 | Professional | None | $67.61 | $112.20 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $91.20 Typical High $602.56 | Facility | None | $67.61 | $91.20 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $117.49 Typical High $223.87 | Professional | None | $60.26 | $117.49 | $223.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $54.95 Median $102.33 Typical High $186.21 | Professional | None | $54.95 | $102.33 | $186.21 |
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 $56.23 Median $114.82 Typical High $251.19 | Professional | None | $56.23 | $114.82 | $251.19 |
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 $26.30 Median $47.86 Typical High $57.54 | Professional | 52 · Reduced service | $26.30 | $47.86 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $19.05 Typical High $22.91 | Professional | 53 · Discontinued | $10.47 | $19.05 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $70.79 Typical High $85.11 | Professional | 54 · Surgery only | $38.90 | $70.79 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $14.13 Typical High $16.98 | Professional | 55 · Aftercare only | $7.94 | $14.13 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $9.55 Typical High $11.48 | Professional | 56 · Pre-op care only | $5.25 | $9.55 | $11.48 |
Where Georgia sits
The same service costs 2.8 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· 21st of 51
$117
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.