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 $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $251.19 | Professional | None | $208.93 | $208.93 | $251.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $208.93 Median $724.44 Typical High $758.58 | Facility | None | $208.93 | $724.44 | $758.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $208.93 Typical High $208.93 | Professional | None | $158.49 | $208.93 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $389.05 Typical High $562.34 | Facility | None | $213.80 | $389.05 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $208.93 Median $229.09 Typical High $524.81 | Professional | None | $208.93 | $229.09 | $524.81 |
United Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $263.03 | Professional | None | $208.93 | $208.93 | $263.03 |
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 $104.71 Median $104.71 Typical High $109.65 | Professional | 52 · Reduced service | $104.71 | $104.71 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $42.66 Typical High $44.67 | Professional | 53 · Discontinued | $42.66 | $42.66 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $33.11 | Professional | 55 · Aftercare only | $31.62 | $31.62 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $22.39 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $22.39 |
Where Georgia sits
The same service costs 1.6 times more in Arizona than in New Jersey. 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· 38th of 51
$209
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.