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 $338.84 Median $5,370.32 Typical High $7,943.28 | Facility | None | $338.84 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $281.84 Typical High $588.84 | Professional | None | $269.15 | $281.84 | $588.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $1,148.15 Typical High $5,754.40 | Facility | None | $575.44 | $1,148.15 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $239.88 Median $371.54 Typical High $588.84 | Professional | None | $239.88 | $371.54 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,995.26 Typical High $2,630.27 | Facility | None | $602.56 | $1,995.26 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $426.58 Typical High $724.44 | Professional | None | $309.03 | $426.58 | $724.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $234.42 Median $302.00 Typical High $426.58 | Professional | None | $234.42 | $302.00 | $426.58 |
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 $275.42 Median $426.58 Typical High $812.83 | Professional | None | $275.42 | $426.58 | $812.83 |
3 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 54 · Surgery only Typical Low $204.17 Median $204.17 Typical High $245.47 | Professional | 54 · Surgery only | $204.17 | $204.17 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $48.98 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $32.36 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $32.36 |
Where Georgia sits
The same service costs 7.2 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· 24th of 51
$457
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.