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 $46.77 Median $5,370.32 Typical High $7,585.78 | Facility | None | $46.77 | $5,370.32 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $74.13 Typical High $194.98 | Professional | None | $46.77 | $74.13 | $194.98 |
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 $66.07 Median $120.23 Typical High $199.53 | Professional | None | $66.07 | $120.23 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $67.61 Typical High $602.56 | Facility | None | $51.29 | $67.61 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $114.82 Typical High $213.80 | Professional | None | $60.26 | $114.82 | $213.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $56.23 Median $104.71 Typical High $177.83 | Professional | None | $56.23 | $104.71 | $177.83 |
United Setting Facility Modifier None Typical Low $79.43 Median $158.49 Typical High $1,778.28 | Facility | None | $79.43 | $158.49 | $1,778.28 |
United Setting Professional Modifier None Typical Low $63.10 Median $109.65 Typical High $199.53 | Professional | None | $63.10 | $109.65 | $199.53 |
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 $23.44 Median $37.15 Typical High $48.98 | Professional | 52 · Reduced service | $23.44 | $37.15 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $14.79 Typical High $19.50 | Professional | 53 · Discontinued | $9.33 | $14.79 | $19.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $54.95 Typical High $74.13 | Professional | 54 · Surgery only | $34.67 | $54.95 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $11.22 Typical High $14.79 | Professional | 55 · Aftercare only | $7.08 | $11.22 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $7.41 Typical High $9.77 | Professional | 56 · Pre-op care only | $4.68 | $7.41 | $9.77 |
Where Georgia sits
The same service costs 3.1 times more in Wisconsin than in Washington, DC. 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· 11th of 51
$120
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.