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 $32.36 Median $4,570.88 Typical High $7,585.78 | Facility | None | $32.36 | $4,570.88 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $32.36 Typical High $85.11 | Professional | None | $25.12 | $32.36 | $85.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $478.63 Median $851.14 Typical High $3,630.78 | Facility | None | $478.63 | $851.14 | $3,630.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $21.38 Median $33.88 Typical High $58.88 | Professional | None | $21.38 | $33.88 | $58.88 |
Cigna Setting Facility Modifier None Typical Low $16.22 Median $21.38 Typical High $776.25 | Facility | None | $16.22 | $21.38 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $50.12 Typical High $85.11 | Professional | None | $28.84 | $50.12 | $85.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $27.54 Median $41.69 Typical High $81.28 | Professional | None | $27.54 | $41.69 | $81.28 |
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 $26.30 Median $42.66 Typical High $77.62 | Professional | None | $26.30 | $42.66 | $77.62 |
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 $12.59 Median $15.85 Typical High $17.38 | Professional | 52 · Reduced service | $12.59 | $15.85 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $6.31 Typical High $7.08 | Professional | 53 · Discontinued | $5.01 | $6.31 | $7.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.05 Median $23.99 Typical High $26.30 | Professional | 54 · Surgery only | $19.05 | $23.99 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $4.79 Typical High $5.25 | Professional | 55 · Aftercare only | $3.80 | $4.79 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $3.16 Typical High $3.55 | Professional | 56 · Pre-op care only | $2.51 | $3.16 | $3.55 |
Where Georgia sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 25th of 51
$39.81
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.