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 $141.25 Median $3,548.13 Typical High $7,585.78 | Facility | None | $141.25 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $154.88 Typical High $371.54 | Professional | None | $97.72 | $154.88 | $371.54 |
Ambetter Setting Professional Modifier None Typical Low $177.83 Median $331.13 Typical High $354.81 | Professional | None | $177.83 | $331.13 | $354.81 |
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 $218.78 Typical High $363.08 | Professional | None | $141.25 | $218.78 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $128.82 Typical High $602.56 | Facility | None | $95.50 | $128.82 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $239.88 Typical High $407.38 | Professional | None | $128.82 | $239.88 | $407.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $123.03 Median $204.17 Typical High $316.23 | Professional | None | $123.03 | $204.17 | $316.23 |
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 $128.82 Median $218.78 Typical High $389.05 | Professional | None | $128.82 | $218.78 | $389.05 |
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 $48.98 Median $70.79 Typical High $95.50 | Professional | 52 · Reduced service | $48.98 | $70.79 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $28.84 Typical High $38.02 | Professional | 53 · Discontinued | $19.50 | $28.84 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $107.15 Typical High $141.25 | Professional | 54 · Surgery only | $74.13 | $107.15 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $21.38 Typical High $28.18 | Professional | 55 · Aftercare only | $14.79 | $21.38 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $14.13 Typical High $19.05 | Professional | 56 · Pre-op care only | $9.77 | $14.13 | $19.05 |
Where Georgia sits
The same service costs 3.7 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· 16th of 51
$234
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.