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 $60.26 Median $5,370.32 Typical High $7,585.78 | Facility | None | $60.26 | $5,370.32 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $138.04 Typical High $354.81 | Professional | None | $60.26 | $138.04 | $354.81 |
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 $74.13 Median $128.82 Typical High $229.09 | Professional | None | $74.13 | $128.82 | $229.09 |
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 $63.10 Median $134.90 Typical High $295.12 | Professional | None | $63.10 | $134.90 | $295.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $64.57 Median $165.96 Typical High $245.47 | Professional | None | $64.57 | $165.96 | $245.47 |
Oscar Health Setting Professional Modifier None Typical Low $89.13 Median $190.55 Typical High $218.78 | Professional | None | $89.13 | $190.55 | $218.78 |
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 $75.86 Median $158.49 Typical High $346.74 | Professional | None | $75.86 | $158.49 | $346.74 |
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 $30.20 Median $63.10 Typical High $79.43 | Professional | 52 · Reduced service | $30.20 | $63.10 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $25.12 Typical High $31.62 | Professional | 53 · Discontinued | $12.02 | $25.12 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $93.33 Typical High $120.23 | Professional | 54 · Surgery only | $45.71 | $93.33 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $18.62 Typical High $23.99 | Professional | 55 · Aftercare only | $9.12 | $18.62 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $12.59 Typical High $15.85 | Professional | 56 · Pre-op care only | $6.03 | $12.59 | $15.85 |
Where Georgia sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 22nd of 51
$141
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.