How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $794.33 Median $794.33 Typical High $794.33 | Facility | None | $794.33 | $794.33 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $954.99 | Professional | None | $794.33 | $794.33 | $954.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $1,819.70 Typical High $4,365.16 | Facility | None | $794.33 | $1,819.70 | $4,365.16 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $912.01 Typical High $1,348.96 | Professional | None | $645.65 | $912.01 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $912.01 Typical High $1,479.11 | Facility | None | $812.83 | $912.01 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $2,630.27 | Professional | None | $67.61 | $67.61 | $2,630.27 |
United Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,230.27 | Professional | None | $794.33 | $794.33 | $1,230.27 |
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 $398.11 Median $398.11 Typical High $478.63 | Professional | 52 · Reduced service | $398.11 | $398.11 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $190.55 | Professional | 53 · Discontinued | $158.49 | $158.49 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $120.23 Typical High $144.54 | Professional | 55 · Aftercare only | $117.49 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $95.50 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $95.50 |
Where Georgia sits
The same service costs 2.6 times more in Alabama than in Florida. 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· 21st of 51
$912
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.