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 $47.86 Median $5,370.32 Typical High $7,585.78 | Facility | None | $47.86 | $5,370.32 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $75.86 Typical High $194.98 | Professional | None | $47.86 | $75.86 | $194.98 |
Ambetter Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $144.54 | Professional | None | $75.86 | $75.86 | $144.54 |
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 $56.23 Median $102.33 Typical High $190.55 | Professional | None | $56.23 | $102.33 | $190.55 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $100.00 Median $154.88 Typical High $288.40 | Professional | 50 · Both sides | $100.00 | $154.88 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $346.74 Typical High $4,265.80 | Facility | None | $50.12 | $346.74 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $104.71 Typical High $204.17 | Professional | None | $56.23 | $104.71 | $204.17 |
Kaiser Permanente Setting Professional Modifier None Typical Low $45.71 Median $79.43 Typical High $158.49 | Professional | None | $45.71 | $79.43 | $158.49 |
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 $57.54 Median $109.65 Typical High $204.17 | Professional | None | $57.54 | $109.65 | $204.17 |
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 $41.69 | Professional | 52 · Reduced service | $23.44 | $37.15 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $14.79 Typical High $16.60 | Professional | 53 · Discontinued | $9.55 | $14.79 | $16.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $54.95 Typical High $63.10 | Professional | 54 · Surgery only | $35.48 | $54.95 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $11.22 Typical High $12.59 | Professional | 55 · Aftercare only | $7.08 | $11.22 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $7.41 Typical High $8.32 | Professional | 56 · Pre-op care only | $4.79 | $7.41 | $8.32 |
Where Georgia sits
The same service costs 3.2 times more in Wisconsin than in Kentucky. 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· 21st of 51
$102
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.