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 $181.97 Median $5,370.32 Typical High $7,943.28 | Facility | None | $181.97 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $181.97 Typical High $245.47 | Professional | None | $169.82 | $181.97 | $245.47 |
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 $181.97 Median $281.84 Typical High $457.09 | Professional | None | $181.97 | $281.84 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $204.17 Typical High $512.86 | Facility | None | $144.54 | $204.17 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $316.23 Typical High $512.86 | Professional | None | $199.53 | $316.23 | $512.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $186.21 Median $223.87 Typical High $478.63 | Professional | None | $186.21 | $223.87 | $478.63 |
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 $213.80 Median $316.23 Typical High $478.63 | Professional | None | $213.80 | $316.23 | $478.63 |
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 $85.11 Median $91.20 Typical High $109.65 | Professional | 52 · Reduced service | $85.11 | $91.20 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $36.31 Typical High $43.65 | Professional | 53 · Discontinued | $33.88 | $36.31 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $134.90 Typical High $165.96 | Professional | 54 · Surgery only | $128.82 | $134.90 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $26.92 Typical High $33.11 | Professional | 55 · Aftercare only | $25.70 | $26.92 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $18.20 Typical High $21.88 | Professional | 56 · Pre-op care only | $16.98 | $18.20 | $21.88 |
Where Georgia sits
The same service costs 3.2 times more in Alaska than in Utah. 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
$288
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.