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 $89.13 Median $4,168.69 Typical High $7,585.78 | Facility | None | $89.13 | $4,168.69 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $154.88 Typical High $363.08 | Professional | None | $79.43 | $154.88 | $363.08 |
Ambetter Setting Professional Modifier None Typical Low $79.43 Median $134.90 Typical High $165.96 | Professional | None | $79.43 | $134.90 | $165.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,000.00 Typical High $4,570.88 | Facility | None | $512.86 | $1,000.00 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $102.33 Median $158.49 Typical High $257.04 | Professional | None | $102.33 | $158.49 | $257.04 |
CareSource Setting Professional Modifier None Typical Low $144.54 Median $154.88 Typical High $169.82 | Professional | None | $144.54 | $154.88 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $125.89 Typical High $660.69 | Facility | None | $95.50 | $125.89 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $177.83 Typical High $316.23 | Professional | None | $81.28 | $177.83 | $316.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $95.50 Median $177.83 Typical High $478.63 | Professional | None | $95.50 | $177.83 | $478.63 |
Oscar Health Setting Professional Modifier None Typical Low $117.49 Median $199.53 Typical High $234.42 | Professional | None | $117.49 | $199.53 | $234.42 |
United Setting Facility Modifier None Typical Low $501.19 Median $724.44 Typical High $3,548.13 | Facility | None | $501.19 | $724.44 | $3,548.13 |
United Setting Professional Modifier None Typical Low $107.15 Median $194.98 Typical High $380.19 | Professional | None | $107.15 | $194.98 | $380.19 |
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 $39.81 Median $61.66 Typical High $77.62 | Professional | 52 · Reduced service | $39.81 | $61.66 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $24.55 Typical High $31.62 | Professional | 53 · Discontinued | $16.22 | $24.55 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $93.33 Typical High $117.49 | Professional | 54 · Surgery only | $60.26 | $93.33 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $18.62 Typical High $23.44 | Professional | 55 · Aftercare only | $12.02 | $18.62 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $12.30 Typical High $15.49 | Professional | 56 · Pre-op care only | $7.94 | $12.30 | $15.49 |
Where Georgia sits
The same service costs 3.2 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· 24th of 51
$170
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.