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 $7.24 Median $5,370.32 Typical High $7,943.28 | Facility | None | $7.24 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $8.51 | Professional | None | $7.24 | $7.24 | $8.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.24 Median $12.88 Typical High $21.38 | Professional | None | $7.24 | $12.88 | $21.38 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $9.12 Median $10.96 Typical High $23.99 | Professional | None | $9.12 | $10.96 | $23.99 |
Kaiser Permanente Setting Professional Modifier None Typical Low $6.76 Median $9.77 Typical High $66.07 | Professional | None | $6.76 | $9.77 | $66.07 |
United Setting Professional Modifier None Typical Low $7.08 Median $11.48 Typical High $22.91 | Professional | None | $7.08 | $11.48 | $22.91 |
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 $3.63 Median $3.63 Typical High $4.27 | Professional | 52 · Reduced service | $3.63 | $3.63 | $4.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.45 Median $1.45 Typical High $1.70 | Professional | 53 · Discontinued | $1.45 | $1.45 | $1.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $5.50 Median $5.50 Typical High $6.31 | Professional | 54 · Surgery only | $5.50 | $5.50 | $6.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.10 Median $1.10 Typical High $1.29 | Professional | 55 · Aftercare only | $1.10 | $1.10 | $1.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.72 Median $0.72 Typical High $0.85 | Professional | 56 · Pre-op care only | $0.72 | $0.72 | $0.85 |
Where Georgia sits
The same service costs 2.3 times more in Hawaii than in North Carolina. 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· 29th of 51
$10.96
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.