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 $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $138.04 | Professional | None | $120.23 | $120.23 | $138.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $120.23 Median $416.87 Typical High $446.68 | Facility | None | $120.23 | $416.87 | $446.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $97.72 Median $120.23 Typical High $123.03 | Professional | None | $97.72 | $120.23 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $223.87 Typical High $323.59 | Facility | None | $138.04 | $223.87 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $309.03 | Professional | None | $131.83 | $131.83 | $309.03 |
United Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $158.49 | Professional | None | $120.23 | $120.23 | $158.49 |
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 $60.26 Median $60.26 Typical High $69.18 | Professional | 52 · Reduced service | $60.26 | $60.26 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $28.18 | Professional | 53 · Discontinued | $23.99 | $23.99 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $20.89 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $13.80 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $13.80 |
Where Georgia sits
The same service costs 1.7 times more in Arizona than in New Mexico. 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· 27th of 51
$120
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.