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 $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $165.96 Median $575.44 Typical High $616.60 | Facility | None | $165.96 | $575.44 | $616.60 |
Anthem BCBS Setting Professional Modifier None Typical Low $144.54 Median $181.97 Typical High $181.97 | Professional | None | $144.54 | $181.97 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $186.21 Typical High $295.12 | Facility | None | $162.18 | $186.21 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $162.18 Median $229.09 Typical High $380.19 | Professional | None | $162.18 | $229.09 | $380.19 |
United Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $208.93 | Professional | None | $158.49 | $158.49 | $208.93 |
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 $79.43 Median $79.43 Typical High $79.43 | Professional | 52 · Reduced service | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | 53 · Discontinued | $31.62 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $23.99 Typical High $23.99 | Professional | 55 · Aftercare only | $23.44 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $15.85 |
Where Georgia sits
The same service costs 1.7 times more in Arizona than in Mississippi. 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· 12th 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.