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 $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $173.78 Typical High $173.78 | Professional | None | $123.03 | $173.78 | $173.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $173.78 Median $389.05 Typical High $954.99 | Facility | None | $173.78 | $389.05 | $954.99 |
Anthem BCBS Setting Professional Modifier None Typical Low $46.77 Median $173.78 Typical High $173.78 | Professional | None | $46.77 | $173.78 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $316.23 Typical High $467.74 | Facility | None | $194.98 | $316.23 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $75.86 | Professional | None | $14.13 | $14.13 | $75.86 |
United Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $158.49 | Professional | None | $91.20 | $91.20 | $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 $61.66 Median $87.10 Typical High $87.10 | Professional | 52 · Reduced service | $61.66 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $34.67 Typical High $34.67 | Professional | 53 · Discontinued | $24.55 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $25.70 Typical High $25.70 | Professional | 55 · Aftercare only | $18.62 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $17.38 Typical High $17.38 | Professional | 56 · Pre-op care only | $12.30 | $17.38 | $17.38 |
Where Georgia sits
The same service costs 3.2 times more in Wyoming than in Oklahoma. 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· 16th of 51
$174
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.