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 $165.96 Median $3,548.13 Typical High $7,585.78 | Facility | None | $165.96 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $181.97 Typical High $229.09 | Professional | None | $144.54 | $181.97 | $229.09 |
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 $141.25 Median $234.42 Typical High $389.05 | Professional | None | $141.25 | $234.42 | $389.05 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $109.65 Median $151.36 Typical High $245.47 | Professional | 62 · Two surgeons | $109.65 | $151.36 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $120.23 Typical High $602.56 | Facility | None | $91.20 | $120.23 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $257.04 Typical High $467.74 | Professional | None | $162.18 | $257.04 | $467.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $151.36 Median $218.78 Typical High $363.08 | Professional | None | $151.36 | $218.78 | $363.08 |
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 $151.36 Median $234.42 Typical High $436.52 | Professional | None | $151.36 | $234.42 | $436.52 |
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 $72.44 Median $91.20 Typical High $112.20 | Professional | 52 · Reduced service | $72.44 | $91.20 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $36.31 Typical High $45.71 | Professional | 53 · Discontinued | $28.84 | $36.31 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $134.90 Typical High $169.82 | Professional | 54 · Surgery only | $109.65 | $134.90 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $26.92 Typical High $33.88 | Professional | 55 · Aftercare only | $21.88 | $26.92 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $18.20 Typical High $22.39 | Professional | 56 · Pre-op care only | $14.45 | $18.20 | $22.39 |
Where Georgia sits
The same service costs 3.4 times more in Alaska than in Pennsylvania. 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· 20th of 51
$240
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.