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 $100.00 Median $5,370.32 Typical High $7,943.28 | Facility | None | $100.00 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $100.00 Typical High $128.82 | Professional | None | $95.50 | $100.00 | $128.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $7,943.28 | Facility | None | $7,943.28 | $7,943.28 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $104.71 Median $158.49 Typical High $257.04 | Professional | None | $104.71 | $158.49 | $257.04 |
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 $112.20 Median $173.78 Typical High $288.40 | Professional | None | $112.20 | $173.78 | $288.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $102.33 Median $123.03 Typical High $263.03 | Professional | None | $102.33 | $123.03 | $263.03 |
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 $109.65 Median $169.82 Typical High $263.03 | Professional | None | $109.65 | $169.82 | $263.03 |
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 $47.86 Median $50.12 Typical High $61.66 | Professional | 52 · Reduced service | $47.86 | $50.12 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $19.95 Typical High $24.55 | Professional | 53 · Discontinued | $19.05 | $19.95 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $75.86 Typical High $93.33 | Professional | 54 · Surgery only | $72.44 | $75.86 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $15.14 Typical High $18.62 | Professional | 55 · Aftercare only | $14.45 | $15.14 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $10.00 Typical High $12.30 | Professional | 56 · Pre-op care only | $9.55 | $10.00 | $12.30 |
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· 28th of 51
$158
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.