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 $831.76 Median $5,011.87 Typical High $7,943.28 | Facility | None | $831.76 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $2,884.03 Typical High $6,309.57 | Professional | None | $223.87 | $2,884.03 | $6,309.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $1,348.96 Typical High $7,244.36 | Facility | None | $691.83 | $1,348.96 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $2,041.74 Typical High $4,677.35 | Professional | None | $218.78 | $2,041.74 | $4,677.35 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $5,011.87 Typical High $6,606.93 | Facility | None | $602.56 | $5,011.87 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $676.08 Typical High $6,165.95 | Professional | None | $269.15 | $676.08 | $6,165.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $208.93 Median $416.87 Typical High $3,548.13 | Professional | None | $208.93 | $416.87 | $3,548.13 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $2,884.03 Typical High $8,709.64 | Facility | None | $1,258.93 | $2,884.03 | $8,709.64 |
United Setting Professional Modifier None Typical Low $263.03 Median $3,235.94 Typical High $6,760.83 | Professional | None | $263.03 | $3,235.94 | $6,760.83 |
6 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 $112.20 Median $199.53 Typical High $1,584.89 | Professional | 52 · Reduced service | $112.20 | $199.53 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $79.43 Typical High $630.96 | Professional | 53 · Discontinued | $44.67 | $79.43 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $295.12 Typical High $2,398.83 | Professional | 54 · Surgery only | $169.82 | $295.12 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $58.88 Typical High $478.63 | Professional | 55 · Aftercare only | $33.88 | $58.88 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $39.81 Typical High $316.23 | Professional | 56 · Pre-op care only | $22.39 | $39.81 | $316.23 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | 51 · Multiple procedures | $194.98 | $194.98 | $194.98 |
Where Georgia sits
The same service costs 11.2 times more in Alaska than in Nebraska. 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· 37th of 51
$2,399
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.