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 $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $79.43 | Professional | None | $75.86 | $75.86 | $79.43 |
Anthem BCBS Setting Professional Modifier None Typical Low $75.86 Median $117.49 Typical High $316.23 | Professional | None | $75.86 | $117.49 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $234.42 Typical High $338.84 | Facility | None | $144.54 | $234.42 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $144.54 | Professional | None | $125.89 | $125.89 | $144.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $114.82 Median $128.82 Typical High $295.12 | Professional | None | $114.82 | $128.82 | $295.12 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $309.03 | Professional | None | $125.89 | $125.89 | $309.03 |
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 $38.02 Median $38.02 Typical High $39.81 | Professional | 52 · Reduced service | $38.02 | $38.02 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $15.85 | Professional | 53 · Discontinued | $15.14 | $15.14 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $11.48 Typical High $11.75 | Professional | 55 · Aftercare only | $11.48 | $11.48 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $7.94 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $7.94 |
Where Georgia sits
The same service costs 3.8 times more in Wyoming than in Kentucky. 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· 17th of 51
$126
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.