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 $75,857.76 Median $75,857.76 Typical High $75,857.76 | Facility | None | $75,857.76 | $75,857.76 | $75,857.76 |
Aetna Setting Professional Modifier None Typical Low $75,857.76 Median $75,857.76 Typical High $75,857.76 | Professional | None | $75,857.76 | $75,857.76 | $75,857.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $75,857.76 Median $173,780.08 Typical High $416,869.38 | Facility | None | $75,857.76 | $173,780.08 | $416,869.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $50,118.72 Median $79,432.82 Typical High $87,096.36 | Professional | None | $50,118.72 | $79,432.82 | $87,096.36 |
Cigna Setting Facility Modifier None Typical Low $77,624.71 Median $87,096.36 Typical High $141,253.75 | Facility | None | $77,624.71 | $87,096.36 | $141,253.75 |
Cigna Setting Professional Modifier None Typical Low $77,624.71 Median $77,624.71 Typical High $77,624.71 | Professional | None | $77,624.71 | $77,624.71 | $77,624.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $34,673.69 Median $34,673.69 Typical High $70,794.58 | Professional | None | $34,673.69 | $34,673.69 | $70,794.58 |
United Setting Professional Modifier None Typical Low $75,857.76 Median $75,857.76 Typical High $91,201.08 | Professional | None | $75,857.76 | $75,857.76 | $91,201.08 |
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 $38,018.94 Median $38,018.94 Typical High $38,018.94 | Professional | 52 · Reduced service | $38,018.94 | $38,018.94 | $38,018.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15,135.61 Median $15,135.61 Typical High $15,135.61 | Professional | 53 · Discontinued | $15,135.61 | $15,135.61 | $15,135.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11,220.18 Median $11,481.54 Typical High $11,481.54 | Professional | 55 · Aftercare only | $11,220.18 | $11,481.54 | $11,481.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7,585.78 Median $7,585.78 Typical High $7,585.78 | Professional | 56 · Pre-op care only | $7,585.78 | $7,585.78 | $7,585.78 |
Where Georgia sits
The same service costs 3.4 times more in Alaska than in Nebraska. 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· 15th of 51
$77,625
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.