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 $331.13 Median $5,370.32 Typical High $7,943.28 | Facility | None | $331.13 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $380.19 | Professional | None | $331.13 | $331.13 | $380.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,168.69 Typical High $5,370.32 | Facility | None | $602.56 | $4,168.69 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $354.81 Median $363.08 Typical High $630.96 | Professional | None | $354.81 | $363.08 | $630.96 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $3,715.35 Typical High $9,549.93 | Facility | None | $1,513.56 | $3,715.35 | $9,549.93 |
United Setting Professional Modifier None Typical Low $346.74 Median $562.34 Typical High $1,000.00 | Professional | None | $346.74 | $562.34 | $1,000.00 |
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 $165.96 Median $165.96 Typical High $186.21 | Professional | 52 · Reduced service | $165.96 | $165.96 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $74.13 | Professional | 53 · Discontinued | $66.07 | $66.07 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $251.19 Typical High $275.42 | Professional | 54 · Surgery only | $251.19 | $251.19 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $54.95 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $37.15 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $37.15 |
Where Georgia sits
The same service costs 4.5 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· 23rd of 51
$468
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.