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 $141.25 Median $3,548.13 Typical High $7,585.78 | Facility | None | $141.25 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $186.21 Typical High $436.52 | Professional | None | $123.03 | $186.21 | $436.52 |
Ambetter Setting Professional Modifier None Typical Low $100.00 Median $173.78 Typical High $380.19 | Professional | None | $100.00 | $173.78 | $380.19 |
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 $141.25 Median $204.17 Typical High $363.08 | Professional | None | $141.25 | $204.17 | $363.08 |
CareSource Setting Professional Modifier None Typical Low $173.78 Median $190.55 Typical High $208.93 | Professional | None | $173.78 | $190.55 | $208.93 |
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 $123.03 Median $269.15 Typical High $389.05 | Professional | None | $123.03 | $269.15 | $389.05 |
Kaiser Permanente Setting Professional Modifier None Typical Low $147.91 Median $218.78 Typical High $316.23 | Professional | None | $147.91 | $218.78 | $316.23 |
Oscar Health Setting Professional Modifier None Typical Low $186.21 Median $245.47 Typical High $363.08 | Professional | None | $186.21 | $245.47 | $363.08 |
United Setting Facility Modifier None Typical Low $331.13 Median $501.19 Typical High $2,454.71 | Facility | None | $331.13 | $501.19 | $2,454.71 |
United Setting Professional Modifier None Typical Low $147.91 Median $239.88 Typical High $457.09 | Professional | None | $147.91 | $239.88 | $457.09 |
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 $61.66 Median $83.18 Typical High $100.00 | Professional | 52 · Reduced service | $61.66 | $83.18 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $33.11 Typical High $39.81 | Professional | 53 · Discontinued | $24.55 | $33.11 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $123.03 Typical High $147.91 | Professional | 54 · Surgery only | $93.33 | $123.03 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $24.55 Typical High $29.51 | Professional | 55 · Aftercare only | $18.62 | $24.55 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $16.60 Typical High $19.95 | Professional | 56 · Pre-op care only | $12.30 | $16.60 | $19.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $114.82 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $87.10 | $114.82 | $138.04 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $162.18 Median $162.18 Typical High $173.78 | Professional | 51 · Multiple procedures | $162.18 | $162.18 | $173.78 |
Where Georgia sits
The same service costs 3.9 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· 20th of 51
$224
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.