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 $416.87 Median $4,466.84 Typical High $7,585.78 | Facility | None | $416.87 | $4,466.84 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $416.87 Typical High $1,071.52 | Professional | None | $165.96 | $416.87 | $1,071.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $478.63 Median $851.14 Typical High $3,630.78 | Facility | None | $478.63 | $851.14 | $3,630.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $208.93 Median $371.54 Typical High $676.08 | Professional | None | $208.93 | $371.54 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $416.87 Typical High $851.14 | Facility | None | $309.03 | $416.87 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $436.52 Typical High $851.14 | Professional | None | $190.55 | $436.52 | $851.14 |
Kaiser Permanente Setting Professional Modifier None Typical Low $173.78 Median $371.54 Typical High $707.95 | Professional | None | $173.78 | $371.54 | $707.95 |
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 $173.78 Median $416.87 Typical High $933.25 | Professional | None | $173.78 | $416.87 | $933.25 |
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 $83.18 Median $194.98 Typical High $229.09 | Professional | 52 · Reduced service | $83.18 | $194.98 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $77.62 Typical High $91.20 | Professional | 53 · Discontinued | $33.11 | $77.62 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $295.12 Typical High $346.74 | Professional | 54 · Surgery only | $125.89 | $295.12 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $58.88 Typical High $69.18 | Professional | 55 · Aftercare only | $25.12 | $58.88 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $38.90 Typical High $45.71 | Professional | 56 · Pre-op care only | $16.60 | $38.90 | $45.71 |
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· 19th of 51
$437
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.