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 $169.82 Median $2,691.53 Typical High $7,413.10 | Facility | None | $169.82 | $2,691.53 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $218.78 Typical High $489.78 | Professional | None | $154.88 | $218.78 | $489.78 |
Ambetter Setting Professional Modifier None Typical Low $181.97 Median $316.23 Typical High $426.58 | Professional | None | $181.97 | $316.23 | $426.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $380.19 Median $776.25 Typical High $3,630.78 | Facility | None | $380.19 | $776.25 | $3,630.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $245.47 Typical High $407.38 | Professional | None | $169.82 | $245.47 | $407.38 |
CareSource Setting Professional Modifier None Typical Low $194.98 Median $208.93 Typical High $229.09 | Professional | None | $194.98 | $208.93 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $173.78 Typical High $602.56 | Facility | None | $128.82 | $173.78 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $354.81 Typical High $575.44 | Professional | None | $199.53 | $354.81 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $194.98 Median $245.47 Typical High $446.68 | Professional | None | $194.98 | $245.47 | $446.68 |
Oscar Health Setting Facility Modifier None Typical Low $1,380.38 Median $1,698.24 Typical High $6,165.95 | Facility | None | $1,380.38 | $1,698.24 | $6,165.95 |
Oscar Health Setting Professional Modifier None Typical Low $234.42 Median $269.15 Typical High $309.03 | Professional | None | $234.42 | $269.15 | $309.03 |
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 $177.83 Median $295.12 Typical High $537.03 | Professional | None | $177.83 | $295.12 | $537.03 |
7 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 $77.62 Median $91.20 Typical High $109.65 | Professional | 52 · Reduced service | $77.62 | $91.20 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $36.31 Typical High $43.65 | Professional | 53 · Discontinued | $30.90 | $36.31 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $138.04 Typical High $165.96 | Professional | 54 · Surgery only | $117.49 | $138.04 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $27.54 Typical High $33.11 | Professional | 55 · Aftercare only | $23.44 | $27.54 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $18.20 Typical High $21.88 | Professional | 56 · Pre-op care only | $15.49 | $18.20 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $128.82 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $109.65 | $128.82 | $154.88 |
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $181.97 Median $398.11 Typical High $398.11 | Professional | 58 · Staged procedure | $181.97 | $398.11 | $398.11 |
Where Georgia sits
The same service costs 4.4 times more in Alaska than in Florida. 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· 20th of 51
$251
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.