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 $138.04 Median $3,548.13 Typical High $7,585.78 | Facility | None | $138.04 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $138.04 Typical High $363.08 | Professional | None | $60.26 | $138.04 | $363.08 |
Ambetter Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $831.76 Typical High $4,570.88 | Facility | None | $389.05 | $831.76 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $74.13 Median $147.91 Typical High $223.87 | Professional | None | $74.13 | $147.91 | $223.87 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $128.82 Median $229.09 Typical High $346.74 | Professional | 50 · Both sides | $128.82 | $229.09 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $851.14 Typical High $1,122.02 | Facility | None | $398.11 | $851.14 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $173.78 Typical High $338.84 | Professional | None | $81.28 | $173.78 | $338.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $70.79 Median $165.96 Typical High $218.78 | Professional | None | $70.79 | $165.96 | $218.78 |
Oscar Health Setting Professional Modifier None Typical Low $97.72 Median $208.93 Typical High $234.42 | Professional | None | $97.72 | $208.93 | $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 $74.13 Median $158.49 Typical High $338.84 | Professional | None | $74.13 | $158.49 | $338.84 |
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 $29.51 Median $69.18 Typical High $79.43 | Professional | 52 · Reduced service | $29.51 | $69.18 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $27.54 Typical High $32.36 | Professional | 53 · Discontinued | $12.02 | $27.54 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $95.50 Typical High $120.23 | Professional | 54 · Surgery only | $44.67 | $95.50 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $20.42 Typical High $23.99 | Professional | 55 · Aftercare only | $8.91 | $20.42 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $13.80 Typical High $15.85 | Professional | 56 · Pre-op care only | $6.03 | $13.80 | $15.85 |
Where Georgia sits
The same service costs 4.9 times more in Alaska than in Hawaii. 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
$162
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.