How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $467.74 Median $467.74 Typical High $537.03 | Facility | None | $467.74 | $467.74 | $537.03 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $537.03 | Professional | None | $467.74 | $467.74 | $537.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $478.63 Median $562.34 Typical High $977.24 | Professional | None | $478.63 | $562.34 | $977.24 |
CareSource Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $630.96 Typical High $1,380.38 | Professional | None | $436.52 | $630.96 | $1,380.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $575.44 Median $741.31 Typical High $2,398.83 | Professional | None | $575.44 | $741.31 | $2,398.83 |
Oscar Health Setting Professional Modifier None Typical Low $537.03 Median $912.01 Typical High $1,202.26 | Professional | None | $537.03 | $912.01 | $1,202.26 |
United Setting Professional Modifier None Typical Low $416.87 Median $645.65 Typical High $1,479.11 | Professional | None | $416.87 | $645.65 | $1,479.11 |
4 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 $234.42 Median $234.42 Typical High $269.15 | Professional | 52 · Reduced service | $234.42 | $234.42 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $109.65 | Professional | 53 · Discontinued | $93.33 | $93.33 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $81.28 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $53.70 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $53.70 |
Where Georgia sits
The same service costs 3.2 times more in Alaska than in New York. 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· 22nd of 51
$562
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.