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 $29.51 Median $5,370.32 Typical High $7,585.78 | Facility | None | $29.51 | $5,370.32 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $45.71 Typical High $112.20 | Professional | None | $29.51 | $45.71 | $112.20 |
Ambetter Setting Professional Modifier None Typical Low $48.98 Median $83.18 Typical High $97.72 | Professional | None | $48.98 | $83.18 | $97.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $32.36 Median $52.48 Typical High $85.11 | Professional | None | $32.36 | $52.48 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $891.25 Typical High $4,265.80 | Facility | None | $501.19 | $891.25 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
Kaiser Permanente Setting Professional Modifier None Typical Low $28.18 Median $47.86 Typical High $61.66 | Professional | None | $28.18 | $47.86 | $61.66 |
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 $34.67 Median $58.88 Typical High $117.49 | Professional | None | $34.67 | $58.88 | $117.49 |
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 $14.79 Median $18.62 Typical High $23.99 | Professional | 52 · Reduced service | $14.79 | $18.62 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $7.41 Typical High $9.55 | Professional | 53 · Discontinued | $5.89 | $7.41 | $9.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $21.88 Median $28.18 Typical High $36.31 | Professional | 54 · Surgery only | $21.88 | $28.18 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $5.62 Typical High $7.24 | Professional | 55 · Aftercare only | $4.47 | $5.62 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $3.72 Typical High $4.79 | Professional | 56 · Pre-op care only | $2.95 | $3.72 | $4.79 |
Where Georgia sits
The same service costs 2.8 times more in Alaska than in California. 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· 30th of 51
$52.48
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.