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 $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $288.40 | Professional | None | $213.80 | $213.80 | $288.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $213.80 Median $741.31 Typical High $794.33 | Facility | None | $213.80 | $741.31 | $794.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $213.80 Typical High $218.78 | Professional | None | $169.82 | $213.80 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $389.05 Typical High $575.44 | Facility | None | $239.88 | $389.05 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $234.42 Median $398.11 Typical High $851.14 | Professional | None | $234.42 | $398.11 | $851.14 |
United Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $275.42 | Professional | None | $213.80 | $213.80 | $275.42 |
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 $107.15 Median $107.15 Typical High $120.23 | Professional | 52 · Reduced service | $107.15 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $42.66 Typical High $48.98 | Professional | 53 · Discontinued | $42.66 | $42.66 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $32.36 Typical High $36.31 | Professional | 55 · Aftercare only | $32.36 | $32.36 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.38 Typical High $24.55 | Professional | 56 · Pre-op care only | $21.38 | $21.38 | $24.55 |
Where Georgia sits
The same service costs 7.6 times more in Alabama than in New Mexico. 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· 26th of 51
$214
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.