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 $141.25 Median $3,548.13 Typical High $7,585.78 | Facility | None | $141.25 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $141.25 Typical High $354.81 | Professional | None | $81.28 | $141.25 | $354.81 |
Ambetter Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
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 $97.72 Median $158.49 Typical High $269.15 | Professional | None | $97.72 | $158.49 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $398.11 Typical High $660.69 | Facility | None | $309.03 | $398.11 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $165.96 Typical High $316.23 | Professional | None | $91.20 | $165.96 | $316.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $85.11 Median $151.36 Typical High $275.42 | Professional | None | $85.11 | $151.36 | $275.42 |
United Setting Facility Modifier None Typical Low $331.13 Median $501.19 Typical High $2,454.71 | Facility | None | $331.13 | $501.19 | $2,454.71 |
United Setting Professional Modifier None Typical Low $85.11 Median $169.82 Typical High $354.81 | Professional | None | $85.11 | $169.82 | $354.81 |
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 $39.81 Median $66.07 Typical High $79.43 | Professional | 52 · Reduced service | $39.81 | $66.07 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $26.92 Typical High $32.36 | Professional | 53 · Discontinued | $16.22 | $26.92 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $100.00 Typical High $120.23 | Professional | 54 · Surgery only | $60.26 | $100.00 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $19.95 Typical High $23.99 | Professional | 55 · Aftercare only | $12.02 | $19.95 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $13.49 Typical High $16.22 | Professional | 56 · Pre-op care only | $8.13 | $13.49 | $16.22 |
Where Georgia sits
The same service costs 3.6 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· 22nd of 51
$178
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.