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 $38.90 Median $3,548.13 Typical High $7,413.10 | Facility | None | $38.90 | $3,548.13 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $56.23 Typical High $112.20 | Professional | None | $38.90 | $56.23 | $112.20 |
Ambetter Setting Professional Modifier None Typical Low $34.67 Median $66.07 Typical High $100.00 | Professional | None | $34.67 | $66.07 | $100.00 |
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 $39.81 Median $67.61 Typical High $104.71 | Professional | None | $39.81 | $67.61 | $104.71 |
CareSource Setting Professional Modifier None Typical Low $46.77 Median $61.66 Typical High $75.86 | Professional | None | $46.77 | $61.66 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $28.18 Median $37.15 Typical High $602.56 | Facility | None | $28.18 | $37.15 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $72.44 Typical High $117.49 | Professional | None | $43.65 | $72.44 | $117.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $41.69 Median $63.10 Typical High $165.96 | Professional | None | $41.69 | $63.10 | $165.96 |
Oscar Health Setting Professional Modifier None Typical Low $54.95 Median $75.86 Typical High $97.72 | Professional | None | $54.95 | $75.86 | $97.72 |
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 $39.81 Median $69.18 Typical High $123.03 | Professional | None | $39.81 | $69.18 | $123.03 |
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 $19.50 Median $24.55 Typical High $29.51 | Professional | 52 · Reduced service | $19.50 | $24.55 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $9.77 Typical High $11.75 | Professional | 53 · Discontinued | $7.76 | $9.77 | $11.75 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.84 Median $37.15 Typical High $43.65 | Professional | 54 · Surgery only | $28.84 | $37.15 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $7.41 Typical High $8.91 | Professional | 55 · Aftercare only | $5.75 | $7.41 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $4.90 Typical High $5.89 | Professional | 56 · Pre-op care only | $3.89 | $4.90 | $5.89 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $41.69 Median $66.07 Typical High $66.07 | Professional | 59 · Distinct service | $41.69 | $66.07 | $66.07 |
Where Georgia sits
The same service costs 4.2 times more in Alaska than in New York. 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· 16th of 51
$67.61
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.