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 $47.86 Median $3,548.13 Typical High $7,585.78 | Facility | None | $47.86 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $57.54 Typical High $134.90 | Professional | None | $42.66 | $57.54 | $134.90 |
Ambetter Setting Professional Modifier None Typical Low $43.65 Median $77.62 Typical High $117.49 | Professional | None | $43.65 | $77.62 | $117.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $7,943.28 | Facility | None | $7,943.28 | $7,943.28 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $67.61 Typical High $109.65 | Professional | None | $50.12 | $67.61 | $109.65 |
CareSource Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $79.43 | Professional | None | $74.13 | $74.13 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $724.44 Typical High $2,691.53 | Facility | None | $501.19 | $724.44 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $93.33 Typical High $151.36 | Professional | None | $57.54 | $93.33 | $151.36 |
Kaiser Permanente Setting Professional Modifier None Typical Low $48.98 Median $67.61 Typical High $102.33 | Professional | None | $48.98 | $67.61 | $102.33 |
Oscar Health Setting Professional Modifier None Typical Low $81.28 Median $89.13 Typical High $114.82 | Professional | None | $81.28 | $89.13 | $114.82 |
United Setting Facility Modifier None Typical Low $79.43 Median $158.49 Typical High $1,778.28 | Facility | None | $79.43 | $158.49 | $1,778.28 |
United Setting Professional Modifier None Typical Low $51.29 Median $83.18 Typical High $144.54 | Professional | None | $51.29 | $83.18 | $144.54 |
5 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 $21.38 Median $25.70 Typical High $30.20 | Professional | 52 · Reduced service | $21.38 | $25.70 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $10.47 Typical High $12.02 | Professional | 53 · Discontinued | $8.71 | $10.47 | $12.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $38.90 Typical High $45.71 | Professional | 54 · Surgery only | $32.36 | $38.90 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $7.76 Typical High $9.12 | Professional | 55 · Aftercare only | $6.46 | $7.76 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $5.25 Typical High $6.03 | Professional | 56 · Pre-op care only | $4.27 | $5.25 | $6.03 |
Where Georgia sits
The same service costs 4.8 times more in Alaska 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· 33rd of 51
$67.61
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.