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 $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $245.47 | Professional | None | $165.96 | $165.96 | $245.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $162.18 Median $562.34 Typical High $602.56 | Facility | None | $162.18 | $562.34 | $602.56 |
Anthem BCBS Setting Professional Modifier None Typical Low $131.83 Median $165.96 Typical High $177.83 | Professional | None | $131.83 | $165.96 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $302.00 Typical High $446.68 | Facility | None | $186.21 | $302.00 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $169.82 Median $181.97 Typical High $758.58 | Professional | None | $169.82 | $181.97 | $758.58 |
United Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $251.19 | Professional | None | $162.18 | $162.18 | $251.19 |
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 $83.18 Median $83.18 Typical High $109.65 | Professional | 52 · Reduced service | $83.18 | $83.18 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $33.11 Typical High $43.65 | Professional | 53 · Discontinued | $33.11 | $33.11 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $24.55 Typical High $33.11 | Professional | 55 · Aftercare only | $24.55 | $24.55 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $16.60 Typical High $21.88 | Professional | 56 · Pre-op care only | $16.60 | $16.60 | $21.88 |
Where Georgia sits
The same service costs 1.6 times more in Arizona than in Rhode Island. 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· 39th of 51
$166
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.