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 $162.18 Median $3,630.78 Typical High $7,943.28 | Facility | None | $162.18 | $3,630.78 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $158.49 Typical High $575.44 | Professional | None | $151.36 | $158.49 | $575.44 |
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 $162.18 Median $251.19 Typical High $407.38 | Professional | None | $162.18 | $251.19 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $204.17 Typical High $251.19 | Facility | None | $162.18 | $204.17 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $281.84 Typical High $501.19 | Professional | None | $177.83 | $281.84 | $501.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $165.96 Median $199.53 Typical High $676.08 | Professional | None | $165.96 | $199.53 | $676.08 |
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 $186.21 Median $275.42 Typical High $416.87 | Professional | None | $186.21 | $275.42 | $416.87 |
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 $75.86 Median $79.43 Typical High $97.72 | Professional | 52 · Reduced service | $75.86 | $79.43 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $31.62 Typical High $38.90 | Professional | 53 · Discontinued | $30.20 | $31.62 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $120.23 Typical High $144.54 | Professional | 54 · Surgery only | $112.20 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $23.99 Typical High $28.84 | Professional | 55 · Aftercare only | $22.39 | $23.99 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.85 Typical High $19.50 | Professional | 56 · Pre-op care only | $15.14 | $15.85 | $19.50 |
Where Georgia sits
The same service costs 3.2 times more in Alaska than in Texas. 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
$257
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.