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 $81.28 Median $3,548.13 Typical High $7,585.78 | Facility | None | $81.28 | $3,548.13 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $83.18 Typical High $158.49 | Professional | None | $58.88 | $83.18 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $83.18 Median $147.91 Typical High $173.78 | Professional | None | $83.18 | $147.91 | $173.78 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $112.20 Median $251.19 Typical High $257.04 | Professional | 50 · Both sides | $112.20 | $251.19 | $257.04 |
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 $72.44 Median $107.15 Typical High $162.18 | Professional | None | $72.44 | $107.15 | $162.18 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $109.65 Median $158.49 Typical High $245.47 | Professional | 50 · Both sides | $109.65 | $158.49 | $245.47 |
CareSource Setting Professional Modifier None Typical Low $74.13 Median $97.72 Typical High $120.23 | Professional | None | $74.13 | $97.72 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $69.18 Typical High $602.56 | Facility | None | $52.48 | $69.18 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $104.71 Typical High $186.21 | Professional | None | $66.07 | $104.71 | $186.21 |
Kaiser Permanente Setting Professional Modifier None Typical Low $58.88 Median $100.00 Typical High $181.97 | Professional | None | $58.88 | $100.00 | $181.97 |
Oscar Health Setting Professional Modifier None Typical Low $87.10 Median $125.89 Typical High $165.96 | Professional | None | $87.10 | $125.89 | $165.96 |
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 $58.88 Median $100.00 Typical High $194.98 | Professional | None | $58.88 | $100.00 | $194.98 |
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 $28.84 Median $36.31 Typical High $43.65 | Professional | 52 · Reduced service | $28.84 | $36.31 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $14.45 Typical High $17.38 | Professional | 53 · Discontinued | $11.75 | $14.45 | $17.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $53.70 Typical High $66.07 | Professional | 54 · Surgery only | $43.65 | $53.70 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $10.72 Typical High $13.18 | Professional | 55 · Aftercare only | $8.71 | $10.72 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $7.24 Typical High $8.71 | Professional | 56 · Pre-op care only | $5.89 | $7.24 | $8.71 |
Where Georgia sits
The same service costs 3.4 times more in Alaska than in Florida. 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· 13th of 51
$107
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.