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 $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $512.86 Typical High $512.86 | Professional | None | $501.19 | $512.86 | $512.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $537.03 Median $1,862.09 Typical High $1,995.26 | Facility | None | $537.03 | $1,862.09 | $1,995.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $467.74 Median $575.44 Typical High $575.44 | Professional | None | $467.74 | $575.44 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $588.84 Typical High $933.25 | Facility | None | $524.81 | $588.84 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $524.81 Median $707.95 Typical High $1,174.90 | Professional | None | $524.81 | $707.95 | $1,174.90 |
United Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $660.69 | Professional | None | $512.86 | $512.86 | $660.69 |
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 $251.19 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $251.19 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $100.00 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $50.12 | $51.29 | $51.29 |
Where Georgia sits
The same service costs 1.7 times more in Arizona than in Hawaii. 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
$537
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.