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 $51.29 Median $5,370.32 Typical High $7,585.78 | Facility | None | $51.29 | $5,370.32 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $125.89 Typical High $323.59 | Professional | None | $51.29 | $125.89 | $323.59 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $257.04 Typical High $257.04 | Professional | None | $114.82 | $257.04 | $257.04 |
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 $63.10 Median $112.20 Typical High $223.87 | Professional | None | $63.10 | $112.20 | $223.87 |
CareSource Setting Professional Modifier None Typical Low $120.23 Median $131.83 Typical High $144.54 | Professional | None | $120.23 | $131.83 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $346.74 Typical High $4,265.80 | Facility | None | $50.12 | $346.74 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $114.82 Typical High $269.15 | Professional | None | $53.70 | $114.82 | $269.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $53.70 Median $147.91 Typical High $181.97 | Professional | None | $53.70 | $147.91 | $181.97 |
Oscar Health Setting Professional Modifier None Typical Low $75.86 Median $169.82 Typical High $194.98 | Professional | None | $75.86 | $169.82 | $194.98 |
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 $64.57 Median $138.04 Typical High $309.03 | Professional | None | $64.57 | $138.04 | $309.03 |
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 $25.70 Median $56.23 Typical High $70.79 | Professional | 52 · Reduced service | $25.70 | $56.23 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $22.39 Typical High $28.84 | Professional | 53 · Discontinued | $10.23 | $22.39 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $85.11 Typical High $107.15 | Professional | 54 · Surgery only | $38.02 | $85.11 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $16.98 Typical High $21.38 | Professional | 55 · Aftercare only | $7.76 | $16.98 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $11.22 Typical High $14.45 | Professional | 56 · Pre-op care only | $5.13 | $11.22 | $14.45 |
Where Georgia sits
The same service costs 3.5 times more in Alaska than in New Jersey. 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
$129
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.