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 $83.18 Median $3,548.13 Typical High $7,585.78 | Facility | None | $83.18 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $93.33 Typical High $218.78 | Professional | None | $53.70 | $93.33 | $218.78 |
Ambetter Setting Professional Modifier None Typical Low $77.62 Median $138.04 Typical High $138.04 | Professional | None | $77.62 | $138.04 | $138.04 |
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 $69.18 Median $125.89 Typical High $204.17 | Professional | None | $69.18 | $125.89 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $77.62 Typical High $602.56 | Facility | None | $58.88 | $77.62 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $128.82 Typical High $239.88 | Professional | None | $69.18 | $128.82 | $239.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $66.07 Median $117.49 Typical High $158.49 | Professional | None | $66.07 | $117.49 | $158.49 |
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 $69.18 Median $123.03 Typical High $229.09 | Professional | None | $69.18 | $123.03 | $229.09 |
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 $26.92 Median $41.69 Typical High $54.95 | Professional | 52 · Reduced service | $26.92 | $41.69 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $16.60 Typical High $21.88 | Professional | 53 · Discontinued | $10.72 | $16.60 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $61.66 Typical High $81.28 | Professional | 54 · Surgery only | $39.81 | $61.66 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $12.30 Typical High $16.60 | Professional | 55 · Aftercare only | $7.94 | $12.30 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $8.32 Typical High $10.96 | Professional | 56 · Pre-op care only | $5.37 | $8.32 | $10.96 |
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· 14th of 51
$135
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.