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 $660.69 Median $5,370.32 Typical High $7,943.28 | Facility | None | $660.69 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $2,570.40 | Professional | None | $660.69 | $660.69 | $2,570.40 |
Ambetter Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $199.53 | Professional | None | $100.00 | $100.00 | $199.53 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $44,668.36 Median $44,668.36 Typical High $44,668.36 | Professional | 50 · Both sides | $44,668.36 | $44,668.36 | $44,668.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $1,148.15 Typical High $5,754.40 | Facility | None | $575.44 | $1,148.15 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $208.93 Typical High $389.05 | Professional | None | $169.82 | $208.93 | $389.05 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $251.19 Median $316.23 Typical High $588.84 | Professional | 50 · Both sides | $251.19 | $316.23 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,238.72 Typical High $2,818.38 | Facility | None | $602.56 | $2,238.72 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $194.98 Typical High $1,995.26 | Professional | None | $87.10 | $194.98 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $51,286.14 | Professional | None | $416.87 | $416.87 | $51,286.14 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $7,585.78 | Facility | None | $954.99 | $1,995.26 | $7,585.78 |
United Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
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 $331.13 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $331.13 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $66.07 |
Where Georgia sits
The same service costs 67.6 times more in Oklahoma than in Montana. 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· 44th of 51
$646
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.