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 $389.05 Median $5,370.32 Typical High $10,000.00 | Facility | None | $389.05 | $5,370.32 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $489.78 | Professional | None | $380.19 | $380.19 | $489.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $1,348.96 Typical High $7,244.36 | Facility | None | $691.83 | $1,348.96 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $389.05 Typical High $1,174.90 | Professional | None | $331.13 | $389.05 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $8,511.38 Typical High $10,964.78 | Facility | None | $602.56 | $8,511.38 | $10,964.78 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $1,000.00 Typical High $1,445.44 | Professional | None | $398.11 | $1,000.00 | $1,445.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $467.74 Median $562.34 Typical High $794.33 | Professional | None | $467.74 | $562.34 | $794.33 |
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 $398.11 Median $616.60 Typical High $1,318.26 | Professional | None | $398.11 | $616.60 | $1,318.26 |
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 $190.55 Median $190.55 Typical High $223.87 | Professional | 52 · Reduced service | $190.55 | $190.55 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $89.13 | Professional | 53 · Discontinued | $75.86 | $75.86 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $281.84 Typical High $331.13 | Professional | 54 · Surgery only | $281.84 | $281.84 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $66.07 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $44.67 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $44.67 |
Where Georgia sits
The same service costs 5.9 times more in Arkansas 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· 38th of 51
$603
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.