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 $35.48 Median $3,548.13 Typical High $7,413.10 | Facility | None | $35.48 | $3,548.13 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $77.62 Typical High $204.17 | Professional | None | $30.90 | $77.62 | $204.17 |
Ambetter Setting Professional Modifier None Typical Low $64.57 Median $95.50 Typical High $173.78 | Professional | None | $64.57 | $95.50 | $173.78 |
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 $37.15 Median $74.13 Typical High $125.89 | Professional | None | $37.15 | $74.13 | $125.89 |
CareSource Setting Professional Modifier None Typical Low $74.13 Median $83.18 Typical High $91.20 | Professional | None | $74.13 | $83.18 | $91.20 |
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 $30.90 Median $72.44 Typical High $177.83 | Professional | None | $30.90 | $72.44 | $177.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $39.81 Median $97.72 Typical High $151.36 | Professional | None | $39.81 | $97.72 | $151.36 |
Oscar Health Setting Facility Modifier None Typical Low $1,023.29 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,023.29 | $1,737.80 | $1,737.80 |
Oscar Health Setting Professional Modifier None Typical Low $47.86 Median $107.15 Typical High $123.03 | Professional | None | $47.86 | $107.15 | $123.03 |
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 $40.74 Median $87.10 Typical High $208.93 | Professional | None | $40.74 | $87.10 | $208.93 |
6 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 $15.49 Median $35.48 Typical High $42.66 | Professional | 52 · Reduced service | $15.49 | $35.48 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $14.13 Typical High $16.98 | Professional | 53 · Discontinued | $6.17 | $14.13 | $16.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $23.44 Median $53.70 Typical High $64.57 | Professional | 54 · Surgery only | $23.44 | $53.70 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $10.72 Typical High $12.88 | Professional | 55 · Aftercare only | $4.68 | $10.72 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $7.08 Typical High $8.51 | Professional | 56 · Pre-op care only | $3.09 | $7.08 | $8.51 |
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $75.86 Median $75.86 Typical High $138.04 | Professional | 58 · Staged procedure | $75.86 | $75.86 | $138.04 |
Where Georgia sits
The same service costs 3.7 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· 21st of 51
$81.28
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.