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 $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $190.55 | Professional | None | $144.54 | $144.54 | $190.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $141.25 Median $489.78 Typical High $512.86 | Facility | None | $141.25 | $489.78 | $512.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $144.54 Typical High $158.49 | Professional | None | $117.49 | $144.54 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $269.15 Typical High $389.05 | Facility | None | $165.96 | $269.15 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $338.84 Typical High $537.03 | Professional | None | $154.88 | $338.84 | $537.03 |
United Setting Professional Modifier None Typical Low $141.25 Median $147.91 Typical High $194.98 | Professional | None | $141.25 | $147.91 | $194.98 |
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 $72.44 Median $72.44 Typical High $95.50 | Professional | 52 · Reduced service | $72.44 | $72.44 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $38.02 | Professional | 53 · Discontinued | $28.84 | $28.84 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $21.88 Typical High $28.18 | Professional | 55 · Aftercare only | $21.88 | $21.88 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $19.05 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $19.05 |
Where Georgia sits
The same service costs 1.5 times more in Arizona than in Oregon. 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· 42nd of 51
$145
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.